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Care Pathway Before Diagnosis of Psychotic Disorder

Am J Psych; ePub 2018 Jan 24; Simon, Stewart, et al

Most patients receiving a first diagnosis of a psychotic disorder had some indication of mental health care need during the previous year, according to a recent study. Electronic health records and insurance claims from 5 large integrated health systems were used to identify 624 patients, aged 15–29 years, who received a first diagnosis of a psychotic disorder in any care setting and to record health services received, diagnoses assigned, and medications dispensed during the previous 36 months. Researchers found:

  • During the year before a first psychotic disorder diagnosis, 29% of patients had mental health specialty outpatient care, 8% had mental health inpatient care, 24% had emergency department mental health care, 29% made a primary care visit with a mental health diagnosis, and 60% received at least 1 mental health diagnosis (including substance use disorders).
  • Compared with patients receiving a first diagnosis of unipolar depression, those with a first diagnosis of a psychotic disorder were modestly more likely to use all types of health services and were specifically more likely to use mental health inpatient care and mental health emergency department care.
Citation:

Simon GE, Stewart C, Hunkeler EM, et al. Care pathways before first diagnosis of a psychotic disorder in adolescents and young adults. [Published online ahead of print January 24, 2018]. Am J Psych. doi:10.1176/appi.ajp.2017.17080844.

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