Effects on referral patterns of reducing intensive informational campaigns about first-episode psychosis

The primary aim of this study was to assess referral patterns and duration of untreated psychosis (DUP) following the partial dismantling of intensive, information campaigns (IC) to help detect first-episode, non-affective psychosis via early detection teams in the TIPS study.

We compared referral patterns of potential cases from the same geographical region (Rogaland County, Norway) referred to low-threshold, rapid-response detection teams at three timepoints: early-IC period (1997-1998), late-IC period (1999-2000) and the no-IC period (2002-2003).

A significant increase occurred in the total number of phone calls, Positive and Negative Syndrome Scale (PANSS)-interviews and referrals from families from the early-to the late-IC period. A comparison of the late-IC period versus no-IC period showed a significant decrease in the number of PANSS-interviews administered, as well as fewer cases referred to the assessment teams. Additionally, a significant decline occurred in the number of referrals from general physicians, whereas the number of direct referrals to the hospital units increased. The DUP increased from a median of 5 to 14 weeks.

External referrals to easy access detection teams occurred more frequently when IC were intensive, especially referrals from families and general practitioners. A shorter DUP was observed in the IC period, suggesting the importance of IC in augmenting the effectiveness of detection teams in identifying first-episode psychosis early in the course of illness.