Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

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.

This Week's Must Reads

Findings from Survey on Sexual Health and Behavior, Arch Sex Behav; ePub 2018 Apr 25; Levine, et al

Resistance Exercise Reduced Depressive Symptoms, JAMA Psychiatry; ePub 2018 May 9; Gordon, et al

Psychiatric Morbidity Incidence in Military Spouses, Depress Anxiety; ePub 2018 May 10; Steenkamp, et al

Weight Suppression/Elevation in Women 50 and Older, Int J Eat Disord; ePub 2018 Apr 25; Goodman, et al

Early Intervention Backed for Early-phase Psychosis, JAMA Psychiatry; ePub 2018 May 2; Correll, et al

Must Reads in Depression

Resistance Exercise Reduced Depressive Symptoms, JAMA Psychiatry; ePub 2018 May 9; Gordon, et al

Psychiatric Morbidity Incidence in Military Spouses, Depress Anxiety; ePub 2018 May 10; Steenkamp, et al

Examining PTSD, Depression, and Suicide in Veterans, Psychiatry Res; ePub 2018 Apr 22; Arenson, et al

Insomnia Mediates Anxiety-Depression Relationship, Depress Anxiety; ePub 2018 Apr 26; Li, Starr, et al

Bullying by Peers and Mental Health in Adolescence, JAMA Psychiatry; ePub 2018 Apr 11; Lee, et al