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Parsing the impact of early detection on duration of untreated psychosis (DUP): Applying quantile regression to data from the Scandinavian TIPS study.

https://arctichealth.org/en/permalink/ahliterature310425
Source
Schizophr Res. 2019 08; 210:128-134
Publication Type
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Date
08-2019
Author
Maria Ferrara
Sinan Guloksuz
Fangyong Li
Shadie Burke
Cenk Tek
Svein Friis
Wenche Ten Velden Hegelstad
Inge Joa
Jan Olav Johannessen
Ingrid Melle
Erik Simonsen
Vinod H Srihari
Author Affiliation
Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, USA; Dipartimento di Salute Mentale e Dipendenze Patologiche, AUSL Modena, viale Muratori 201, 41121 Modena, Italy. Electronic address: maria.ferrara@yale.edu.
Source
Schizophr Res. 2019 08; 210:128-134
Date
08-2019
Language
English
Publication Type
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Keywords
Adult
Early Diagnosis
Early Medical Intervention - statistics & numerical data
Female
Humans
Male
Norway - epidemiology
Prospective Studies
Psychotic Disorders - diagnosis - epidemiology - therapy
Schizophrenia - diagnosis - epidemiology - therapy
Sex Factors
Time-to-Treatment - statistics & numerical data
Young Adult
Abstract
Prolonged duration of untreated psychosis (DUP) is associated with poor outcomes. The TIPS study halved DUP with an early detection (ED) campaign; however, conventional statistical analyses, focused on mean estimates, failed to reveal the effects of ED across the full DUP distribution, restricting inferences about ED's effectiveness. Utilizing a novel quantile regression based analysis, we examined the differential impact of ED across DUP. Secondary analysis explored possible predictors of DUP, and moderators of the effect of the campaign.
The TIPS ED campaign was conducted in two health care sectors in Norway, with two equivalent health care sectors serving as controls. Quantile regression analysis was performed to analyze ED campaign's effect.
281 patients with first episode psychosis were recruited, including 141 from the ED area. ED had no effect on the first quartile (Q1) of DUP, whereas a significant reduction in Q2 (11weeks), and Q3 (41weeks) of DUP was observed. The effect of ED was significantly stronger on reducing Q3 than Q1 or Q2, suggesting that the campaign was more effective in longer DUP samples. Male gender and single status predicted longer DUP in Q3: by 38 and 27weeks, respectively. Single status, but not gender, emerged as a significant moderator of ED campaign effect.
Quantile regression provided in depth information about the non-uniformity, and moderators, of TIPS's ED effort across the full distribution of DUP, demonstrating the value of this analytic approach to re-examine prior, and plan analyses for future, early detection efforts.
PubMed ID
31204063 View in PubMed
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Determinants of duration of untreated psychosis among first-episode psychosis patients in Denmark: A nationwide register-based study.

https://arctichealth.org/en/permalink/ahliterature295757
Source
Schizophr Res. 2018 02; 192:154-158
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2018
Author
Lene Halling Hastrup
Ulrik Helt Haahr
Jens Einar Jansen
Erik Simonsen
Author Affiliation
Psychiatric Research Unit, Region Zealand Psychiatry, Denmark. Electronic address: lhhs@regionsjaelland.dk.
Source
Schizophr Res. 2018 02; 192:154-158
Date
02-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Age of Onset
Awareness
Demography
Denmark - epidemiology
Early Intervention (Education)
Female
Humans
Male
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - epidemiology - psychology
Registries
Young Adult
Abstract
Information on determinants of duration of untreated psychosis (DUP) is still needed to inform campaigns targeting people with first episode psychosis (FEP). This nation-wide study analysed the association between demographic factors (age, sex, ethnicity, marital status, and geographic area), premorbid and illness-related factors (global functional level, substance misuse, and contact to police), healthcare factors (referral source and first FEP contact) and DUP.
The study population of 1266 patients aged 15-25years diagnosed with FEP (ICD10 F20.0-F20.99) was drawn from the Danish National Indicator Project during 2009-2011. The study population was combined with data from national administrative registers. A multinomial regression model was estimated to analyse the impact of demographic, premorbid and illness-related, and healthcare factors on DUP.
One third of the population had a DUP below 6months. DUP longer than 12months was associated with older age at onset, being female, having cannabis misuse, and living in peripheral municipalities. Being charged by the criminal authorities during one year before FEP was associated with a DUP over 6months.
DUP is related to a number of demographic, premorbid and healthcare factors. These findings suggest that future information campaigns should focus on increasing the awareness of early signs of psychosis not only among mental health professionals but also other professionals in contact with adolescents such as the police. It may also be useful to consider how to target information campaigns towards persons living in peripheral areas.
PubMed ID
28578812 View in PubMed
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Continuity between interview-rated personality disorders and self-reported DSM-5 traits in a Danish psychiatric sample.

https://arctichealth.org/en/permalink/ahliterature291088
Source
Personal Disord. 2017 Jul; 8(3):261-267
Publication Type
Journal Article
Date
Jul-2017
Author
Bo Bach
Jaime Anderson
Erik Simonsen
Author Affiliation
Research Unit, Region Zealand.
Source
Personal Disord. 2017 Jul; 8(3):261-267
Date
Jul-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Denmark
Female
Humans
Interview, Psychological - standards
Male
Personality Disorders - diagnosis - physiopathology
Personality Inventory - standards
Psychiatric Status Rating Scales - standards
Young Adult
Abstract
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Section III offers an alternative model for the diagnosis of personality disorders (PDs), including 25 pathological personality trait facets organized into 5 trait domains. To maintain continuity with the categorical PD diagnoses found in DSM-5 Section II, specified sets of facets are configured into familiar PD types. The current study aimed to evaluate the continuity across the Section II and III models of PDs. A sample of 142 psychiatric outpatients were administered the Personality Inventory for DSM-5 and rated with the Structured Clinical Interview for the DSM-IV Axis II disorders. We investigated whether the DSM-5 Section III facet-profiles would be associated with their respective Section II counterparts, as well as determining whether additional facets could augment the prediction of the Section II disorders. Results showed that, overall, the interview-rated DSM-5 Section II disorders were most strongly associated with expected self-reported Section III traits. Results also supported the addition of facets not included in the proposed Section III PD criteria. These findings partly underscore the continuity between the Section II and III models of PDs and suggest how it may be enhanced; however, additional research is needed to further evaluate where continuity exists, where it does not exist, and how the traits system could be improved. (PsycINFO Database Record
PubMed ID
26784892 View in PubMed
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