Treatment Delays in Youth with a First Episode of Psychosis: Relationship to Pre-Onset Sub-Threshold Symptoms

Poster B115, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Sarah McIlwaine1,2, Sally Mustafa2, Rachel Rosengard1,2, Anne Crawford2, Martin Lepage1,2, Srividya Iyer1,2, Ridha Joober1,2, Ashok Malla1,2, Jai Shah1,2; 1Department of Psychiatry, McGill University, Montreal, Québec, Canada, 2Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Québec, Canada

PURPOSE: The duration of untreated psychosis (DUP), or the time between illness onset and initiation of treatment, is key to symptom remission and recovery for a first episode of psychosis (FEP). The World Health Organization suggests that specialized treatment for psychosis be initiated within the first 3 months of the illness’ onset. As a result, research has focused on factors that are associated with DUP. One such variable, until now unexamined, is the presence or absence of a clinical high-risk state (CHR) prior to FEP onset. CHR states may render the pre-psychosis phase more severe, thus potentially altering the pathways to care of help-seeking individuals. METHODS: Using retrospective symptom recall and pathways to care data from the Circumstances of Onset and Relapse Schedule for 382 individuals, we determined whether the presence of a CHR state prior to a FEP significantly lengthened the duration of the prodrome phase, duration of untreated illness (DUI), and DUP (including the time to first help-seeking contact). RESULTS: Those experiencing a pre-onset CHR state endured a longer prodrome (p = .002), a longer time between illness onset and first help-seeking contact (p = .0046), and a longer DUI (p = .0214). CONCLUSIONS: These findings suggest that a CHR state prior to a FEP can have an important impact on an individual’s propensity to initiate contact with services, and consequently lengthen the time that their illness is left untreated.

Topic Area: Ultra High Risk / Prodromal Research

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