A study on the pathway to care among patients with first episode psychosis attending a tertiary health care center in North Karnataka

Abstract

ABSTRACT Context: Early treatment of schizophrenia and other psychotic disorders has a significant impact on the prognosis and outcome of these disorders. To reduce the time of untreated psychosis, it is necessary to know the help-seeking behavior and the path taken by the patients and their caregivers. Efforts at reducing the time to initiate treatment for first-episode psychosis (FEP) are very much needed. The pathway to care helps in determining various factors associated with the delay and also creates awareness regarding the negative pathway determinants. Aim: This study aims to find out the pathway to care in FEP. Settings and Design: This is a hospital-based, time-bound, cross-sectional study, conducted from January to June 2022 in the department of psychiatry of a tertiary health care center in North Karnataka. Subjects and Methods: Basic sociodemographic, clinical, and details related to pathway to care were collected using semi-structured pro forma. MINI plus 5.0.0 and International Classification of Diseases-10 DCR were used to assess and confirm the diagnosis. Brief Psychiatric Rating Scale was used to measure the severity of symptoms. Statistical Analysis: Data were compiled and appropriate statistical tests were used to analyze the data with the help of SPSS version 17.0. Results: Sixty-one cases of FEP were assessed. The majority (44.2%) of the cases were diagnosed with acute and transient psychotic disorders and 16.4% were schizophrenia. The median duration of untreated psychosis was 30 days (15–150 days). For the majority (54.1%) of the patients, first contact was faith healers and for 31.1%, it was mental health facilities. Conclusion: The most common pathway taken by the patients was faith healers as they were easily available in rural areas and free from stigma associated with mental illness. These findings can be utilized in making policies to increase awareness about mental health and also about the availability of mental health services.