Don’t turn your back on the symptoms of psychosis: a proof-of-principle, quasi-experimental public health trial to reduce the duration of untreated psychosis in Birmingham, UK

BMC Psychiatry

Swaran Singh¹  Paul Patterson⁷  Helen Lester⁵  Nick Freemantle²  Sunita Channa⁴  Colin Palmer⁴  Max Birchwood³  Charlotte Connor⁶ 

[1] Mental Health & Wellbeing, Medical School Building, Gibbet Hill Campus, University of Warwick, CV4 7AL, Coventry, UK;Clinical Epidemiology & Biostatistics, Department of Primary Care and Population Health, UCL Medical School (Royal Free Campus), Rowland Hill Street, NW3 2PF, London, UK;Youthspace Mental Health Service, Birmingham and Solihull Mental Health Foundation Trust, Edgbaston, B15 2TT, Birmingham, UK;CLAHRC, Birmingham & Solihull Mental Health Foundation Trust, 66-68 Hagley Road, B16 8PF, Birmingham, UK;Primary Care, Primary Care Clinical Sciences, School of Health and Population Sciences, Primary Care Clinical Sciences Building, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK;School of Psychology, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK;Youthspace, Birmingham & Solihull Mental Health Foundation Trust, 66-68 Hagley Road, B16 8PF, Birmingham, UK

关键词: Youth mental health;    Duration of untreated psychosis;    Early detection;    First-episode psychosis;    Public mental health campaign;   

Others  :  1124126
DOI  :  10.1186/1471-244X-13-67

 received in 2012-12-03, accepted in 2013-02-13,  发布年份 2013

【 摘 要 】

Background

Reducing the duration of untreated psychosis (DUP) is an aspiration of international guidelines for first episode psychosis; however, public health initiatives have met with mixed results. Systematic reviews suggest that greater focus on the sources of delay within care pathways, (which will vary between healthcare settings) is needed to achieve sustainable reductions in DUP (BJP 198: 256-263; 2011).

Methods/Design

A quasi-experimental trial, comparing a targeted intervention area with a ‘detection as usual’ area in the same city. A proof-of–principle trial, no a priori assumptions are made regarding effect size; key outcome will be an estimate of the potential effect size for a definitive trial. DUP and number of new cases will be collected over an 18-month period in target and control areas and compared; historical data on DUP collected in both areas over the previous three years, will serve as a benchmark. The intervention will focus on reducing two significant DUP component delays within the overall care pathway: delays within the mental health service and help-seeking delay.

Discussion

This pragmatic trial will be the first to target known delays within the care pathway for those with a first episode of psychosis. If successful, this will provide a generalizable methodology that can be implemented in a variety of healthcare contexts with differing sources of delay.

Trial registration

http://www.controlled-trials.com/ISRCTN45058713 webcite

【 授权许可】

   
2013 Connor et al; licensee BioMed Central Ltd.

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