Patient and Physician Factors Associated with First Diagnosis of Non-affective Psychotic Disorder in Primary Care.
Early intervention
Family physicians
Health administrative data
Pathways to care
Primary care
Psychosis
Journal
Administration and policy in mental health
ISSN: 1573-3289
Titre abrégé: Adm Policy Ment Health
Pays: United States
ID NLM: 8914574
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
accepted:
20
10
2022
pubmed:
21
11
2022
medline:
18
2
2023
entrez:
20
11
2022
Statut:
ppublish
Résumé
Primary care physicians play a central role in pathways to care for first-episode psychosis, and their increased involvement in early detection could improve service-related outcomes. The aim of this study was to estimate the proportion of psychosis first diagnosed in primary care, and identify associated patient and physician factors. We used linked health administrative data to construct a retrospective cohort of people aged 14-35 years with a first diagnosis of non-affective psychosis in Ontario, Canada between 2005-2015. We restricted the sample to patients with help-seeking contacts for mental health reasons in primary care in the six months prior to first diagnosis of psychotic disorder. We used modified Poisson regression models to examine patient and physician factors associated with a first diagnosis of psychosis in primary care. Among people with early psychosis (n = 39,449), 63% had help-seeking contacts in primary care within six months prior to first diagnosis. Of those patients, 47% were diagnosed in primary care and 53% in secondary/tertiary care. Patients factors associated with lower likelihood of diagnosis in primary care included male sex, younger age, immigrant status, and comorbid psychosocial conditions. Physician factors associated with lower likelihood of diagnosis in primary care included solo practice model, urban practice setting, international medical education, and longer time since graduation. Our findings indicate that primary care is an important contact for help-seeking and diagnosis for a large proportion of people with early psychosis. For physicians less likely to diagnose psychosis in primary care, targeted resources and interventions could be provided to support them in caring for patients with early psychosis.
Identifiants
pubmed: 36403173
doi: 10.1007/s10488-022-01233-y
pii: 10.1007/s10488-022-01233-y
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
212-224Subventions
Organisme : CIHR
ID : PJT 153022
Pays : Canada
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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