Treatment Delay and Pathways to Care in First Episode Psychosis

The aim of this study was investigation the duration of untreated psychosis (DUP), associated factors and pathways to care among patients with first episode psychosis admitted to Roozbeh Hospital. In this cross-sectional study, 91 patients with the diagnosis of first episode psychosis admitted to Roozbeh Hospital in Tehran, were assessed regarding the duration of untreated psychosis (DUP, defined as the duration between the appearance of first symptoms of psychosis and the time of the first adequate treatment or admission to the hospital), pathways to care and mode of illness onset. Data were analyzed using the Mann-Whitney test, Kruskall Wallis test, and Spearman’s Correlation Coefficient. In 35.2% of the subjects, the illness had an acute mode of onset (less than two weeks). Regarding the type of disorders, bipolar disorder (29.7%) and schizophrenia (19.8) constituted the most prevalent diagnoses. Mean DUP was 52.03 weeks (with a standard deviation of 114.7 weeks). Most patients were seen by psychiatrists and the second most people referred to were traditional healers. Referrals to Roozbeh Hospital were mostly by family and friends. In this study DUP was longer in patients living in urban areas (p<0.01), the unemployed (p<0.01), the ones with schizophrenia (p<0.05), and those with a gradual onset of illness (i.e. more than two weeks) (p<0.00l). DUP and its relation with different factors were to an extent similar to other studies. However, in Iran a higher number of patients with first episode psychosis see traditional healers.