Associations between rural/urban status, duration of untreated psychosis and mode of onset of psychosis: A mental health electronic clinical records analysis in the East of England, UK

Kaminska, Karolina, Hodgekins, Joanne, Lewis, Jonathan R., Cardinal, Rudolf N. and Oduola, Sherifat ORCID: https://orcid.org/0000-0002-7227-9536 (2024) Associations between rural/urban status, duration of untreated psychosis and mode of onset of psychosis: A mental health electronic clinical records analysis in the East of England, UK. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954

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Abstract

Purpose: The influence of rurality on the duration of untreated psychosis (DUP) in first-episode psychosis (FEP) is poorly understood. We investigated factors associated with FEP in rural/urban settings and whether there are rural/urban differences in DUP and the mode (speed) of onset of psychosis.   Methods: We used the Cambridgeshire and Peterborough NHS Foundation Trust Research Database (CPFTRD) to identify all persons presenting to an early intervention for psychosis service with FEP between 2013 and 2015. We performed descriptive statistics and multivariable linear and multinomial regression to assess the relationships between the study outcomes and the independent variables.   Results: One hundred and fifty-five FEP patients were identified, with a mean age of 23.4 (SD, 5.3) years. The median DUP was 129.0 (IQR: 27.5–524.0) days. In rural areas, FEP patients were more likely to be employed and live with family than those in urban areas. A longer DUP was observed among patients with an insidious onset of psychosis compared with an acute onset (619.5 (IQR: 333.5–945.0)) vs. (17.0 (IQR: 8.0–30.5)) days respectively, p < 0.0001. We found evidence that the mode of onset of psychosis differed by employment status and living circumstances. There was insufficient evidence of rural/urban differences in DUP and mode of onset of psychosis.   Conclusions: Our results suggest that the mode of onset of psychosis is an important indicator of treatment delay and could provide vital information for service planning and delivery. Sociodemographic variations in FEP exist in rural populations, and our findings are similar to those observed in urban settings.

Item Type: Article
Additional Information: Acknowledgements: The CPFT Research Database is supported by the NIHR Cambridge Biomedical Research Centre (NIHR203312) and the NIHR Applied Research Collaboration East of England; the views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. SO is supported by the National Institute for Health Research (NIHR) (Ref: NIHR HS&DR 131871, MHDA 207498 and PDG 203683).
Uncontrolled Keywords: duration of untreated psychosis,first-episode psychosis,rural,sociodemographic characteristics,urban,health(social science),psychiatry and mental health,social psychology,epidemiology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/3300/3306
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Mental Health
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Faculty of Medicine and Health Sciences > Research Centres > Population Health
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Depositing User: LivePure Connector
Date Deposited: 10 Sep 2024 11:30
Last Modified: 25 Sep 2024 18:08
URI: https://ueaeprints.uea.ac.uk/id/eprint/96631
DOI: 10.1007/s00127-024-02758-3

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