Early intervention: factors associated with the increasing of the duration of untreated psychosis (DUP) - a systematic review

• Autor(a) principal: Ana Teresa Soares Cruz
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/128829
• topic: Ciências médicas e da saúde; Medical and Health sciences

Introduction: Episodes of psychosis can interfere severely with patient's quality of life and implies a high global burden. Understanding the causes and consequences of untreated psychosis is important to help improve targeted therapeutic strategies and public health initiatives, because community ignorance and poor health literacy form obstacles to having systems that focus on early intervention. To reduce the delay in early intervention and thereby achieve a most personalized intervention, it's very important to identify predictors of long DUP. Material and Methods: A research of the last twenty years of literature data was performed and 32 studies were included. Results: Sociodemographic (sex, substance abuse, ethnicity and employed/unemployed) and clinical characteristics (age of onset, negative symptoms, premorbid adjustment and type of psychosis) were evaluated. No consensual results were found regarding these characteristics. When remission was evaluated, long DUP was associated with a longer period for achieving remission. Conclusion: The major objective is to improve the outcome and change the trajectory of the disease, with greater functionality for the patient. We must consider the patient holistically and recognize the factors that pretentiously can prolong DUP, because identifying only one characteristic is not enough since there is a huge interaction between them, and this will be important to know when we evaluate this factors in patients. Identification of prodromal and inaugural negative symptoms by improving awareness of population about mental health and expertise of psychiatry by health care providers may promote earlier detection of psychosis and a better outcome, through strategies that associate pharmacotherapy, psychotherapy and psychosocial approaches.