Racial differences in pathways to care preceding first episode mania or psychosis: a historical cohort prodromal study.
bipolar disorder
first episode mania
first episode psychosis
prodrome
schizophrenia
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2023
2023
Historique:
received:
16
06
2023
accepted:
16
08
2023
medline:
21
9
2023
pubmed:
21
9
2023
entrez:
21
9
2023
Statut:
epublish
Résumé
There is evidence suggesting racial disparities in diagnosis and treatment in bipolar disorder (BD) and schizophrenia (SZ). The purpose of this study is to compare psychiatric diagnoses and psychotropic use preceding a first episode of mania (FEM) or psychosis (FEP) in racially diverse patients. Using a comprehensive medical records linkage system (Rochester Epidemiology Project, REP), we retrospectively identified individuals diagnosed with BD or SZ and a documented first episode of mania or psychosis. Illness trajectory before FEP/FEM were characterized as the time from first visit for a mental health complaint to incident case. Pathways to care and clinical events preceding FEP/FEM were compared based on subsequent incident case diagnosis (BD or SZ) and self-reported race (White vs. non-White). A total of 205 (FEM = 74; FEP = 131) incident cases were identified in the REP. Duration of psychiatric antecedents was significantly shorter in non-White patients, compared to White patients (2.2 ± 4.3 vs. 7.4 ± 6.6 years; These data are unable to ascertain reasons for shorter duration of psychiatric antecedents and later age of seeking care, and more broadly first age of initial symptom presentation. If symptoms are confirmed to be earlier than first time seeking care in both groups, it would be important to identify barriers that racial minorities face to access timely psychiatric care and optimize early intervention strategies.
Sections du résumé
Background
UNASSIGNED
There is evidence suggesting racial disparities in diagnosis and treatment in bipolar disorder (BD) and schizophrenia (SZ). The purpose of this study is to compare psychiatric diagnoses and psychotropic use preceding a first episode of mania (FEM) or psychosis (FEP) in racially diverse patients.
Methods
UNASSIGNED
Using a comprehensive medical records linkage system (Rochester Epidemiology Project, REP), we retrospectively identified individuals diagnosed with BD or SZ and a documented first episode of mania or psychosis. Illness trajectory before FEP/FEM were characterized as the time from first visit for a mental health complaint to incident case. Pathways to care and clinical events preceding FEP/FEM were compared based on subsequent incident case diagnosis (BD or SZ) and self-reported race (White vs. non-White).
Results
UNASSIGNED
A total of 205 (FEM = 74; FEP = 131) incident cases were identified in the REP. Duration of psychiatric antecedents was significantly shorter in non-White patients, compared to White patients (2.2 ± 4.3 vs. 7.4 ± 6.6 years;
Conclusion
UNASSIGNED
These data are unable to ascertain reasons for shorter duration of psychiatric antecedents and later age of seeking care, and more broadly first age of initial symptom presentation. If symptoms are confirmed to be earlier than first time seeking care in both groups, it would be important to identify barriers that racial minorities face to access timely psychiatric care and optimize early intervention strategies.
Identifiants
pubmed: 37732076
doi: 10.3389/fpsyt.2023.1241071
pmc: PMC10507622
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1241071Subventions
Organisme : NIA NIH HHS
ID : R33 AG058738
Pays : United States
Informations de copyright
Copyright © 2023 Gardea-Resendez, Ortiz-Orendain, Miola, Fuentes Salgado, Ercis, Coombes, Gruhlke, Bostwick, Michel, Vande Voort, Ozerdem, McKean, Frye and Taylor-Desir.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
N Engl J Med. 2020 Jul 2;383(1):58-66
pubmed: 32609982
J Clin Psychopharmacol. 2022 Mar-Apr 01;42(2):159-162
pubmed: 35230047
Front Psychiatry. 2019 Oct 24;10:774
pubmed: 31708822
Pharmacoepidemiol Drug Saf. 2015 Nov;24(11):1197-206
pubmed: 26132170
Br J Psychiatry. 2006 Sep;189:235-40
pubmed: 16946358
Med Care Res Rev. 2010 Jun;67(3):342-63
pubmed: 19915066
Psychosom Med. 2022 Jan 1;84(1):97-103
pubmed: 34611111
Gen Hosp Psychiatry. 2017 Mar - Apr;45:32-39
pubmed: 28274336
J Clin Psychiatry. 2003 Jul;64(7):747-54
pubmed: 12934973
Harv Rev Psychiatry. 2023 Jan-Feb 01;31(1):28-36
pubmed: 36608081
Psychiatr Serv. 2004 Jun;55(6):677-84
pubmed: 15175466
Bipolar Disord. 2018 Sep;20(6):506-514
pubmed: 29527766
Int J Bipolar Disord. 2017 Dec;5(1):7
pubmed: 28155207
Am J Psychiatry. 2021 Jul;178(7):599-610
pubmed: 33934608
Early Interv Psychiatry. 2022 Apr;16(4):342-351
pubmed: 33951751
Int J Epidemiol. 2018 Apr 1;47(2):368-368j
pubmed: 29346555
Rheumatology (Oxford). 2011 Jan;50(1):6-15
pubmed: 20627969
J Am Acad Child Adolesc Psychiatry. 2011 Feb;50(2):160-70
pubmed: 21241953
Bipolar Disord. 2014 Aug;16(5):478-92
pubmed: 24597782
NPJ Schizophr. 2021 Dec 2;7(1):58
pubmed: 34857754
Eur Child Adolesc Psychiatry. 2023 Apr 7;:
pubmed: 37027026
Bipolar Disord. 2019 Dec;21(8):720-740
pubmed: 31479581
J Affect Disord. 2020 Jan 1;260:361-365
pubmed: 31539671
J Affect Disord. 2023 Nov 1;340:25-32
pubmed: 37506772
Discov Ment Health. 2022;2(1):7
pubmed: 35310132
Schizophr Res. 2008 Jan;98(1-3):287-94
pubmed: 18031996
BMC Psychiatry. 2020 Feb 19;20(1):75
pubmed: 32075625
J Clin Psychiatry. 2003 Feb;64(2):161-74
pubmed: 12633125
Am J Psychiatry. 2021 Jul;178(7):592-598
pubmed: 34270343
J Affect Disord. 2016 Apr;194:120-7
pubmed: 26820761
J Racial Ethn Health Disparities. 2017 Jun;4(3):354-363
pubmed: 27129856
Front Psychiatry. 2020 Jun 11;11:500
pubmed: 32595530
Arch Gen Psychiatry. 2005 Mar;62(3):247-53
pubmed: 15753237
J Racial Ethn Health Disparities. 2023 Feb;10(1):367-372
pubmed: 35064520
Mayo Clin Proc. 2012 Feb;87(2):151-60
pubmed: 22305027
Nat Rev Dis Primers. 2018 Mar 08;4:18008
pubmed: 29516993
Am J Psychiatry. 2016 Jul 1;173(7):695-704
pubmed: 26892940
Schizophrenia (Heidelb). 2022 May 19;8(1):52
pubmed: 35854023
Am J Psychiatry. 1983 Dec;140(12):1571-4
pubmed: 6650685
JAMA Psychiatry. 2021 Mar 1;78(3):311-319
pubmed: 33355626
Front Psychiatry. 2023 Feb 09;14:1098292
pubmed: 36846217
J Affect Disord. 1996 Jul 8;39(2):157-62
pubmed: 8827426
J Clin Psychiatry. 2022 Mar 21;83(3):
pubmed: 35324095