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Acta Psychiatr Scand. 2016 Sep;134(3):225-33. doi: 10.1111/acps.12600. Epub 2016 Jun 13.

Increased use of primary care during 6 years of prodromal schizophrenia.

Author information

1
Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.
2
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
3
Research Unit for General Practice, Aarhus University, Aarhus, Denmark.
4
Psychiatric Center Copenhagen, Copenhagen University, Copenhagen, Denmark.
5
National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.

Abstract

BACKGROUND:

Early diagnosis is important for the course of schizophrenia.

AIM:

To investigate whether prodromal symptoms of schizophrenia lead to increased use of primary care.

METHOD:

A register-based cohort study of 21 894 cases with incident schizophrenia and 437 880 matched controls.

RESULTS:

Cases used daytime primary care 43% more than controls during the 6 years before diagnosis (IRR = 1.43; 95% CI: 1.39; 1.48) and 132% more during the last 2 months (IRR = 2.32; 95% CI: 2.27; 2.37), and 34% (IRR = 1.34; 95% CI: 1.23; 1.48) vs. 374% more for out-of-hours services (IRR = 3.74; 95% CI: 3.52; 3.98). Six years before index diagnosis, 30% of cases had at least one psychiatric contact without being diagnosed with schizophrenia, increasing to 75% 1 month before diagnosis.

CONCLUSION:

Increased help-seeking behaviour was seen at least 6 years before index diagnosis, suggesting a 'window' for earlier diagnosis of prodromal schizophrenia.

KEYWORDS:

epidemiology; first episode; general practice; schizophrenia

PMID:
27295520
DOI:
10.1111/acps.12600
[Indexed for MEDLINE]

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