tiffanybangles11

Discussion

The findings from our systematic review on the pathways to care of patients with FEP suggest that the type of contact differs depending on whether the first contact or the referral source is considered. These contact points represent different time-periods in the course of illness, and may suggest a failure to identify previously untreated patients with psychotic return to tiffany presenting to a general practitioner. This could be because the symptoms are subtle, the assessment contact is too brief, or the presentation of a psychotic disorder is an infrequent event in a general practice. The care pathways also differed by geographical region, probably because of differences in social, cultural, and health service contexts. These regional trends highlight the need for tiffany 1837 that is specific to the jurisdiction of interest.

Our findings support prior claims that involuntary and negative pathways to care, such as with police or emergency services, are frequent for patients with FEP (Garety & Rigg, 2001). This is of particular concern given that negative pathways to care may be associated with poor engagement in treatment (Compton, 2005) and greater dissatisfaction with services (Bhugra et al. 2004). Qualitative research on help-seeking in FEP also indicates that negative experiences with psychiatric tiffany somerset may have an impact on future delays in help-seeking (Monteiro et al. 2006). Taken together, these findings suggest that we need to pay greater attention to the potentially deleterious impact of the involvement of police, ambulance, and emergency services on the pathway to care.

Contacts with non-physicians tended to be infrequent relative to contacts with physicians and emergency services, except in some specific Asian jurisdictions. tiffanys et al. (1998) suggest that non-physician contacts may be involved as part of a 'parallel help-seeking strategy', which would not be captured by the indices used by the included studies. Qualitative research on help-seeking in early psychosis indicates that non-physician contacts play an important role in linking the families of patients with psychiatric services (Wong, 2007 a , b ) and families may use personal contacts as resources to expedite the help-seeking process (Bergner et al. 2008). There is also evidence that patients tend to under-report contact with non-physician services, possibly because of the perception that informal contacts do not warrant equal status on the help-seeking pathway (Lincoln & McGorry, 1995).

The studies that explored the sex, tiffany bangles uk-economic, or ethnic determinants of the pathways to care had conflicting findings, probably reflective of contextual differences across studies. In addition, the objective of the included studies was generally not to explore the sociodemographic determinants of the pathway to care, but rather to use these variables as covariates for other analyses. Of exception, several studies did focus on ethnic differences as the primary objective. The included studies were also limited in their power to explore these determinants, and future research may obtain a better understanding from studies that are designed and powered to examine the sociodemographic determinants of the pathway to care.