Parnassia Psychiatric Institute, Prinsegracht 63, 2512EX, The Hague, The Netherlands.
Schizophr Res. 2011 Nov;132(2-3):213-9. doi: 10.1016/j.schres.2011.08.009. Epub 2011 Sep 9.
Knowledge of pathways to care by help-seeking patients prior to the onset of psychosis may help to improve the identification of at-risk patients. This study explored the history of help-seeking behavior in secondary mental health care services prior to the onset of the first episode of psychosis.
The psychiatric case register in The Hague was used to identify a cohort of 1753 people in the age range of 18-35 at first contact who developed a psychotic disorder in the period from 1 January 2005 to 31 December 2009. We retrospectively examined the diagnoses made at first contact with psychiatric services.
985 patients (56.2%) had been treated in secondary mental health services prior to the onset of psychosis. The most common disorders were mood and anxiety disorders (N=385 (39.1%)) and substance use disorders (N=211 (21.4%)). Affective psychoses were more often preceded by mood/anxiety disorders, while psychotic disorder NOS was more often preceded by personality disorder or substance abuse. The interval between first contact and first diagnosis of psychosis was approximately 69 months in cases presenting with mood and anxiety disorders and 127 months in cases presenting with personality disorders.
This study confirms the hypothesis that the majority of patients with psychotic disorders had been help-seeking for other mental disorders in the secondary mental health care prior to the onset of psychosis.
了解精神病发作前寻求帮助的患者的就医途径，可能有助于提高对高危患者的识别能力。本研究探讨了首次精神病发作前在二级精神卫生服务中寻求帮助的历史。
使用海牙的精神病病例登记处，确定了一个年龄在 18-35 岁之间的队列，这些人在 2005 年 1 月 1 日至 2009 年 12 月 31 日期间首次接触时患有精神病。我们回顾性地检查了首次接触精神卫生服务时做出的诊断。
985 名（56.2%）患者在精神病发作前曾在二级精神卫生服务机构接受过治疗。最常见的疾病是情绪和焦虑障碍（N=385（39.1%））和物质使用障碍（N=211（21.4%））。情感性精神病更常以前有情绪/焦虑障碍，而精神病NOS 更常以前有人格障碍或物质滥用。出现情绪和焦虑障碍的患者从首次接触到首次诊断为精神病的间隔约为 69 个月，而出现人格障碍的患者间隔约为 127 个月。
本研究证实了这样一种假设，即大多数精神病患者在精神病发作前曾在二级精神卫生保健机构因其他精神障碍寻求帮助。
