Department of Psychiatry, Queen Mary Hospital, University of Hong Kong, 102, Pokfulam Road, Hong Kong SAR, China,
Soc Psychiatry Psychiatr Epidemiol. 2013 Nov;48(11):1819-28. doi: 10.1007/s00127-013-0688-9. Epub 2013 Apr 26.
Delay in receiving treatment in psychosis may lead to adverse consequences. We examined the predictors for help-seeking duration in adult-onset psychosis Chinese patients in Hong Kong. We hypothesized that factors which are more related to the illness manifestation would be predictive of waiting time before any help-seeking initiation, and factors which are more related to one's knowledge about mental health services would be predictive of help-seeking duration.
First-episode patients with psychosis were recruited from the Jockey Club Early Psychosis project. They were asked to report retrospectively all help-seeking behaviors involved since their first occurrence of psychotic symptoms until receipt of effective psychiatric treatment. Baseline characteristics, pre-morbid functioning and traits, and mode of illness onset were assessed.
Help-seeking pattern was analyzed in 360 patients who had subsequently reached the psychiatric services. They had an average of 2.5 help-seeking contacts. Nearly half of the first help-seeking process was initiated by family members. Only 1 % approached priests or traditional healers as the first step in help-seeking. Whereas a gradual mode of onset was significantly associated with longer waiting time to first help-seeking initiation, more premorbid schizoid and schizotypal traits and a migrant status were related to longer help-seeking duration.
Current findings suggested that family members were the key decision makers in initiating help-seeking. Longer help-seeking duration in migrants has significant implications to both local and global mental health policy.
精神疾病治疗延误可能导致不良后果。我们考察了香港成年起病精神疾病患者寻求帮助时间的预测因素。我们假设,与疾病表现更相关的因素将预测首次寻求帮助前的等待时间,而与精神卫生服务相关知识更相关的因素将预测寻求帮助的时间。
首发精神疾病患者从赛马会早期精神病项目中招募。他们被要求回顾性地报告自首次出现精神病症状到接受有效精神科治疗期间所有涉及的寻求帮助行为。评估了基线特征、病前功能和特征以及发病模式。
分析了 360 名随后获得精神科服务的患者的寻求帮助模式。他们平均有 2.5 次寻求帮助的接触。近一半的首次寻求帮助过程是由家庭成员发起的。只有 1%的人求助于牧师或传统治疗师作为寻求帮助的第一步。而逐渐发病模式与首次寻求帮助的等待时间延长显著相关,而更多的病前分裂样和分裂型特质以及移民身份与寻求帮助的时间延长有关。
目前的研究结果表明,家庭成员是启动寻求帮助的关键决策者。移民中较长的寻求帮助时间对当地和全球精神卫生政策都有重要意义。