Kvig Erling Inge, Brinchmann Beate, Moe Cathrine, Nilssen Steinar, Larsen Tor Ketil, Sørgaard Knut
Nordland Hospital Trust, Tromsø, Norway.
Psychopathology. 2017;50(4):282-289. doi: 10.1159/000478989. Epub 2017 Aug 11.
BACKGROUND/AIMS: Studies of pathways to care in first-episode psychosis have documented a substantial treatment delay occurring after patients enter mental health services. An initial presentation with neurotic rather than psychotic symptoms is common in first-episode psychosis. The term "lanthanic patient" has been used to refer to patients presenting with a reason for help-seeking that is unrelated to the underlying pathology. The aim of this study is to explore whether a lanthanic presentation is related to prolonged service delay.
The sample comprises 62 patients with recent-onset psychosis. Data on sociodemographic, clinical, help-seeking, and pathway indicators were collected using a comprehensive, semistructured-interview schedule.
Service delay accounted for more than half of the overall treatment delay. An initially presenting complaint of neurotic symptoms was related to prolonged service delay. The effect remained after controlling for other potential risk factors of service delay.
Anomalous experiences of pleasure, desire, or motivation are common in emerging psychosis. These difficulties are often misinterpreted as complaints of depression and anxiety by health professionals. The presence of such symptoms can introduce a focal vision on the part of health care professionals on the immediate presentation rather than the underlying psychopathology, leading to the underdetection of psychosis.
背景/目的：对首发精神病患者就医途径的研究表明，患者进入精神卫生服务机构后会出现显著的治疗延迟。在首发精神病中，最初表现为神经症症状而非精神病症状的情况很常见。“迟缓型患者”一词用于指那些因与潜在病理无关的原因寻求帮助的患者。本研究的目的是探讨迟缓型表现是否与服务延迟延长有关。
样本包括62例近期发病的精神病患者。使用全面的半结构化访谈时间表收集社会人口统计学、临床、求助和就医途径指标的数据。
服务延迟占总体治疗延迟的一半以上。最初表现为神经症症状的主诉与服务延迟延长有关。在控制了服务延迟的其他潜在风险因素后，这种影响仍然存在。
在新发精神病中，愉悦、欲望或动机方面的异常体验很常见。这些困难常常被卫生专业人员误解为抑郁和焦虑的主诉。这些症状的存在可能会使卫生保健专业人员将注意力集中在即时表现而非潜在的精神病理学上，从而导致精神病的漏诊。
