Hui Christy Lai-Ming, Lau Winnie Wing-Yin, Leung Chung-Ming, Chang Wing-Chung, Tang Jennifer Yee-Man, Wong Gloria Hoi-Yan, Chan Sherry Kit-Wa, Lee Edwin Ho-Ming, Chen Eric Yu-Hai
Department of Psychiatry, University of Hong Kong, Hong Kong.
Early Interv Psychiatry. 2015 Apr;9(2):118-25. doi: 10.1111/eip.12094. Epub 2013 Sep 30.
Understanding factors that contribute to treatment delay would inform early detection and intervention strategies in psychotic disorders. However, existing data were mixed and primarily conducted among early-onset young patients. We examined duration of untreated psychosis (DUP) and its clinical and sociodemographic correlates in a large cohort of adult-onset patients with psychosis.
A total of 360 patients with first-onset psychosis aged 26-55 years were recruited consecutively as part of a controlled study of an early psychosis intervention service in Hong Kong Chinese. Demographic, sociodemographic and clinical characteristics relating to DUP were assessed within 4 months of onset.
The population had a mean onset age of 36.6 years (SD = 8.7). The mean and median DUP were 515 days (SD = 1091) and 93 days (inter-quartile range from 20 to 382.3), respectively. Multivariate regression analysis suggested that insidious mode of onset, hospitalization, a diagnosis of schizophrenia, poorer insight and younger age at onset significantly prolonged DUP. DUP was not related to premorbid functioning, family involvement during help seeking and living alone.
The initial period of untreated psychosis is determined by multiple factors. Whether family involvement is considered a kind of social support in shortening or prolonging DUP needs further examination. Local early intervention program for psychosis should take reference from these findings when formulating personalized plans to reduce delay.
了解导致治疗延迟的因素将为精神障碍的早期检测和干预策略提供依据。然而，现有数据参差不齐，且主要是在早发性年轻患者中进行的。我们在一大群成年期发病的精神病患者中研究了未治疗精神病的持续时间（DUP）及其临床和社会人口学相关因素。
作为香港华人早期精神病干预服务对照研究的一部分，连续招募了360名年龄在26 - 55岁之间的首发精神病患者。在发病后4个月内评估与DUP相关的人口统计学、社会人口学和临床特征。
该人群的平均发病年龄为36.6岁（标准差 = 8.7）。DUP的均值和中位数分别为515天（标准差 = 1091）和93天（四分位间距为20至382.3）。多变量回归分析表明，隐匿性起病方式、住院治疗、精神分裂症诊断、自知力较差以及发病年龄较小会显著延长DUP。DUP与病前功能、寻求帮助期间的家庭参与情况以及独居无关。
未治疗精神病的初始阶段由多种因素决定。家庭参与在缩短或延长DUP方面是否被视为一种社会支持需要进一步研究。当地的精神病早期干预项目在制定个性化计划以减少延迟时应参考这些发现。
