Predictors of help-seeking duration in adult-onset psychosis in Hong Kong

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 48; no. 11; pp. 1819 - 1828
• Main Authors: Hui, Christy L. M., Tang, Jennifer Y. M., Wong, Gloria H. Y., Chang, W. C., Chan, Sherry K. W., Lee, Edwin H. M., Chen, Eric Y. H.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2013; Springer; Springer Nature B.V
• Subjects: Adult; Adult and adolescent clinical studies; Age of Onset; Analysis; Asian Continental Ancestry Group - psychology; Behavior; Biological and medical sciences; Delayed Diagnosis; Epidemiology; Family; Female; Gender; Health services; Health Services Accessibility - statistics & numerical data; Hong Kong; Humans; Interview, Psychological; Male; Medical policy; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Mental disorders; Mental health; Mental health care; Mental Health Services - statistics & numerical data; Mental Health Services - utilization; Middle Aged; Original Paper; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Psychiatric services; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychosis; Psychotic Disorders - diagnosis; Psychotic Disorders - psychology; Psychotic Disorders - therapy; Retrospective Studies; Schizophrenia; Socioeconomic Factors; Systematic review; Time Factors; Young Adult; Hong Kong; Asia; China; Hong Kong China; Schizophrenia; Duration of untreated psychosis; Early psychosis; Pathways; Help-seeking; Human; Help seeking; Mental health; Psychosis; Adult; Early; Predictive factor; Public health
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-013-0688-9

Purpose Delay in receiving treatment in psychosis may lead to adverse consequences. We examined the predictors for help-seeking duration in adult-onset psychosis Chinese patients in Hong Kong. We hypothesized that factors which are more related to the illness manifestation would be predictive of waiting time before any help-seeking initiation, and factors which are more related to one’s knowledge about mental health services would be predictive of help-seeking duration. Methods First-episode patients with psychosis were recruited from the Jockey Club Early Psychosis project. They were asked to report retrospectively all help-seeking behaviors involved since their first occurrence of psychotic symptoms until receipt of effective psychiatric treatment. Baseline characteristics, pre-morbid functioning and traits, and mode of illness onset were assessed. Results Help-seeking pattern was analyzed in 360 patients who had subsequently reached the psychiatric services. They had an average of 2.5 help-seeking contacts. Nearly half of the first help-seeking process was initiated by family members. Only 1 % approached priests or traditional healers as the first step in help-seeking. Whereas a gradual mode of onset was significantly associated with longer waiting time to first help-seeking initiation, more premorbid schizoid and schizotypal traits and a migrant status were related to longer help-seeking duration. Conclusions Current findings suggested that family members were the key decision makers in initiating help-seeking. Longer help-seeking duration in migrants has significant implications to both local and global mental health policy.