Most patients seek help for other mental health conditions in the year prior to being diagnosed with a psychotic disorder, according to new study findings.
The recent cohort study published in JAMA Psychiatry shed light on mental health service use patterns and diagnostic trajectories of young people in the years leading up to their first diagnosis of a psychotic disorder.
The study analyzed linked health administrative data from Ontario, Canada, to compare 10,501 patients aged 15 to 29 years who received a first diagnosis of a psychotic disorder with matched controls who received a first diagnosis of a mood disorder between April 1, 2012, and March 31, 2018.
Among the patients, 72% had at least 1 mental health service visit in the 3 years prior to their diagnosis, compared to 67% in the mood disorder control group.
Notably, individuals with psychotic disorders had higher rates of mental health-related hospital admissions and emergency department visits in the 3 years preceding their diagnosis compared to the control group. In the outpatient setting, 30% of patients with a first psychotic disorder diagnosis had visited a psychiatrist in the 3 years prior, compared to 18% of those with a first mood disorder diagnosis.
The study also found patients with psychotic disorders had a greater diversity of diagnoses preceding their index diagnosis. For instance, compared to the control group, patients with psychotic disorders were more likely to have had prior diagnoses of substance use disorders, personality disorders, developmental disorders, and self-harm.
The researchers emphasized that acute care settings, such as emergency departments and hospitals, may be particularly important for research and education efforts aimed at improving the early detection of psychotic disorders in youth.
While the study's large, representative sample and adjustment for major risk factors were strengths, the researchers acknowledged limitations, including the reliance on administrative data and the inability to investigate mental health care visits with non-physician practitioners.
Conflict of interest disclosures can be found in the published research study.