Duration of Untreated Psychosis and the Pathway to Care in KwaZulu-Natal, South Africa

作者：Tomita Andrew^*; Burns Jonathan K; King Howard; Baumgartner Joy Noel; Davis Glen P; Mtshemla Sisanda; Nene Siphumelele; Susser Ezra

来源：Journal of Nervous and Mental Disease, 2015, 203(3): 222-225.

DOI：10.1097/NMD.0000000000000268

• Pathway to care
• duration of untreated psychosis
• traditional health practitioner
• severe mental illness
• South Africa

Considerable controversy surrounds the role of traditional health practitioners (THPs) as first-contact service providers and their influence on the duration of untreated psychosis (DUP) in sub-Saharan Africa. This study examined first-contact patterns and pathways to psychiatric care among individualswith severe mental illness in South Africa. A cross-sectional study was conducted at a referral-based tertiary psychiatric government hospital in KwaZulu-Natal Province. Information on pathways to care was collected using the World Health Organization's Encounter Form. General hospital was the most common first point of contact after mental disorder symptom onset and the strongest link to subsequent psychiatric treatment. Family members were the most common initiators in seeking care. First contact with THPs was associated with longer DUP and higher number of provider contacts in the pathway based on adjusted regression analyses. Strengthening connections between psychiatric and general hospitals and provision of culturally competent family-based psychoeducation to reduce DUP are warranted.

• 出版日期2015-3