Department of Psychiatry and Behavioral Sciences (Saavedra, Crisanti, Lardier, Tohen, Lenroot, Bustillo, Halperin, Friedman) and Student Health and Counseling (McIver), University of New Mexico, Albuquerque; Weill Institute for Neurosciences, University of California San Francisco, San Francisco (Loewy); Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh (Murray-Krezan).
Psychiatr Serv. 2024 Feb 1;75(2):161-166. doi: 10.1176/appi.ps.20230005. Epub 2023 Aug 9.
Programs for early detection of psychosis help identify individuals experiencing emerging psychosis and link them with appropriate services, thereby reducing the duration of untreated psychosis (DUP). The authors used the cascade-of-care framework to identify various care stages between screening and enrollment in coordinated specialty care (CSC) and to determine attrition at each stage, with the goal of identifying points in the referral process that may affect DUP.
Project partners included a college counseling center and CSC program. All college students seeking mental health services at a counseling center between 2020 and 2022 (N=1,945) completed the Prodromal Questionnaire-Brief (PQ-B) at intake. Students who met the distress cutoff score were referred for a phone screening. Those who met criteria on the basis of this screening were referred for assessment and possible enrollment into CSC.
Six stages in the cascade of care for early detection were identified. Of the students who completed the PQ-B as part of intake (stage 1), 547 (28%) met the PQ-B cutoff score (stage 2). Counselors referred 428 (78%) students who met the PQ-B cutoff score (stage 3), and 212 (50%) of these students completed the phone screening (stage 4). Seventy-two (34%) students completed a CSC eligibility assessment (stage 5), 21 (29%) of whom were enrolled in CSC (stage 6).
The cascade-of-care framework helped conceptualize the flow within a program for early psychosis detection in order to identify stages that may contribute to lengthier DUP. Future research is warranted to better understand the factors that contribute to DUP at these stages.
早期精神病检测计划有助于识别出现精神病前期症状的个体，并将他们与适当的服务联系起来，从而缩短未经治疗的精神病持续时间（DUP）。作者使用了护理级联框架来确定在筛查和接受协调专业护理（CSC）之间的各个护理阶段，并确定每个阶段的流失情况，目的是确定转诊过程中可能影响 DUP 的点。
项目合作伙伴包括一个大学咨询中心和 CSC 项目。所有在 2020 年至 2022 年期间在咨询中心寻求心理健康服务的大学生（N=1,945）在入学时都完成了前驱症状问卷-简短版（PQ-B）。达到困扰得分截点的学生被转介进行电话筛查。根据该筛查标准符合条件的学生被转介进行评估，并可能入组 CSC。
确定了早期检测护理级联的六个阶段。在作为入学程序一部分完成 PQ-B 的学生中（第 1 阶段），有 547 名（28%）达到 PQ-B 截止分数（第 2 阶段）。辅导员转介了 428 名（78%）达到 PQ-B 截止分数的学生（第 3 阶段），其中 212 名（50%）学生完成了电话筛查（第 4 阶段）。72 名（34%）学生完成了 CSC 资格评估（第 5 阶段），其中 21 名（29%）入组 CSC（第 6 阶段）。
护理级联框架有助于概念化早期精神病检测计划中的流程，以确定可能导致更长 DUP 的阶段。未来的研究需要更好地了解这些阶段导致 DUP 的因素。
