Pathways to psychosis: help-seeking behavior in the prodromal phase

Area of Science:

• Psychiatry
• Mental Health Services Research

Background:

• Identifying individuals at risk for psychosis is crucial for timely intervention.
• Understanding help-seeking pathways before psychosis onset can improve early detection.

Purpose of the Study:

• To investigate the history of help-seeking behavior in secondary mental health care services before the onset of the first psychotic episode.

Main Methods:

• A cohort of 1753 individuals aged 18-35 who developed a psychotic disorder between 2005-2009 was identified using The Hague psychiatric case register.
• Retrospective examination of diagnoses made at first contact with psychiatric services was performed.

Main Results:

• Over half (56.2%) of patients received secondary mental health care before psychosis onset.
• Mood and anxiety disorders (39.1%) and substance use disorders (21.4%) were the most common preceding conditions.
• The time to psychosis diagnosis varied significantly based on preceding disorders, with mood/anxiety disorders averaging 69 months and personality disorders 127 months.

Conclusions:

• The majority of patients with psychotic disorders had prior contact with secondary mental health services for other mental health conditions.
• These findings underscore the potential for identifying and intervening with at-risk populations before the onset of psychosis.