Geographical accessibility and duration of untreated psychosis: distance as a determinant of treatment delay

BMC Psychiatry

Research Article

Steinar Nilssen¹  Cathrine Moe²  Erling Inge Kvig³  Beate Brinchmann³  Knut Sørgaard³  Tor Ketil Larsen⁴ 

[1] Helgeland hospital Trust, Mo i Rana, Norway;Nord University, Bodø, Norway;Nordland hospital Trust, Bodø, Norway;UIT The Arctic University of Norway, Tromsø, Norway;Stavanger University Hospital, Stavanger, Norway;University of Bergen, Bergen, Norway;

关键词: Dup;    Treatment delay;    Pathways;    Accessibility;    Psychosis;   

DOI  :  10.1186/s12888-017-1345-8

 received in 2016-12-22, accepted in 2017-05-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe duration of untreated psychosis is determined by both patient and service related factors. Few studies have considered the geographical accessibility of services in relation to treatment delay in early psychosis. To address this, we investigated whether treatment delay is co-determined by straight-line distance to hospital based specialist services in a mainly rural mental health context.MethodsA naturalistic cross-sectional study was conducted among a sample of recent onset psychosis patients in northern Norway (n = 62). Data on patient and service related determinants were analysed.ResultsHalf of the cohort had a treatment delay longer than 4.5 months. In a binary logistic regression model, straight-line distance was found to make an independent contribution to delay in which we controlled for other known risk factors.ConclusionsThe determinants of treatment delay are complex. This study adds to previous studies on treatment delay by showing that the spatial location of services also makes an independent contribution. In addition, it may be that insidious onset is a more important factor in treatment delay in remote areas, as the logistical implications of specialist referral are much greater than for urban dwellers. The threshold for making a diagnosis in a remote location may therefore be higher. Strategies to reduce the duration of untreated psychosis in rural areas would benefit from improving appropriate referral by crisis services, and the detection of insidious onset of psychosis in community based specialist services.

【 授权许可】

CC BY   
© The Author(s). 2017