Declining transition rates to psychosis: the contribution of potential changes in referral pathways to an ultra-high-risk service
Declining transition rates to psychosis: the contribution of potential changes in referral pathways to an ultra-high-risk service
复制标题
DOI：
10.1111/eip.12105
复制
发表时间：
2015-06-01
影响因子：
2
通讯作者：
Yung, Alison R.
中科院分区：
文献类型：
--
作者：
Wiltink, Suzanne;Velthorst, Eva;Yung, Alison R.
目的在应用超高危（UHR）标准的基础上，报告了最初向精神病转变的高比率。然而，近年来观察到向精神病转变的情况有所下降。目前的描述性文件的目的是调查，如果这种下降的过渡率可能是由于潜在的变化模式的转介到一个大的UHR clinic.Methods150年轻人谁被称为个人评估和危机评估（PACE）诊所在墨尔本，澳大利亚，2000年8月至2004年7月之间。他们的转介途径进行了评估，使用半结构化的采访。结果PACE门诊就诊前的平均接触次数为1.93次（标准差（SD）=1.15），症状发作至PACE门诊就诊的平均时间为46.5周（SD=57.4）。与早期队列（平均值=2.36; SD=1.32）相比，我们的结果表明接触次数较少（Cohen d=0.35，r=0.17）。此外，当前研究的参与者被转介到PACE诊所的速度加快了一倍。结论专业人员和普通人群对UHR症状的认识不断提高，似乎导致年轻人更快地被转介到专门的心理健康服务机构。全球过渡率下降可能是由于UHR服务转介途径的变化。
AimOn the basis of applying ultra-high-risk' (UHR) criteria, initially high rates of transition to psychosis were reported. However, a decline in transition to psychosis has been observed in recent years. The current descriptive paper aims to investigate if this drop in transition rate may be due to potential changes in patterns of referral to a large UHR clinic.MethodsOne hundred fifty young people who were referred to the Personal Assessment and Crisis Evaluation (PACE) Clinic in Melbourne, Australia, between August 2000 and July 2004 were included. Their referral pathways were assessed using a semistructured interview. Results were compared with a similar study of a cohort referred to the same clinic between 1995 and 1996.ResultsThe mean number of contacts prior to referral to the PACE Clinic was 1.93 (standard deviation (SD)=1.15), and the average time between symptom onset and referral to PACE was 46.5 weeks (SD=57.4). In comparison with the earlier cohort (mean=2.36; SD=1.32), our results indicate a lower number of contacts (Cohen's d=0.35, r=0.17). Furthermore, participants in the current study were referred twice as fast to the PACE Clinic.ConclusionsIncreasing awareness of UHR symptoms among professionals and in the general population seems to have resulted in faster referral of young people to specialized mental health services. The global drop in transition rate might be due to a change in referral pathways to UHR services.