Abstract：
OBJECTIVE: Lengthy duration of untreated psychosis (DUP) and duration of untreated illness (DUI) in people at clinical high-risk for psychosis (CHR-P) and first episode psychosis (FEP) is associated with poorer outcomes. However, individuals with FEP often experience negative pathways to care involving contacts with police, crisis services and requiring compulsory admissions, and evidence suggests individuals with both FEP and CHR-P often experience lengthy delays to treatment. Early detection interventions, such as public health interventions, may be one way to reduce delays. This systematic review aimed to synthesise the available evidence on such interventions.
METHODS: The EMBASE, PsychINFO, CINAHL, and MEDLINE databases were searched. Studies were included if they compared an intervention designed to improve timely access to treatment for individuals with FEP or CHR-P to standard treatment provision. Interventions may be targeted at potential patients, their families, the general public, or non-healthcare professionals. Outcomes of interest were DUP or DUI, and/or characteristics of pathways to care.
RESULTS: Nineteen studies met the inclusion criteria. All consisted of FEP populations, none of CHR-P populations. Employing narrative synthesis, we found mixed results about the effectiveness of interventions at reducing DUP and interventions appeared to differentially impact groups. Pathways to care information was limited and mixed.
CONCLUSIONS: Findings on the effectiveness of interventions designed to improve timely access to treatment were inconclusive. More research is warranted to better understand where delays occur and factors which may influence this for both FEP and CHR-P populations which may help to develop targeted interventions to address delays.
METHODS: The EMBASE, PsychINFO, CINAHL, and MEDLINE databases were searched. Studies were included if they compared an intervention designed to improve timely access to treatment for individuals with FEP or CHR-P to standard treatment provision. Interventions may be targeted at potential patients, their families, the general public, or non-healthcare professionals. Outcomes of interest were DUP or DUI, and/or characteristics of pathways to care.
RESULTS: Nineteen studies met the inclusion criteria. All consisted of FEP populations, none of CHR-P populations. Employing narrative synthesis, we found mixed results about the effectiveness of interventions at reducing DUP and interventions appeared to differentially impact groups. Pathways to care information was limited and mixed.
CONCLUSIONS: Findings on the effectiveness of interventions designed to improve timely access to treatment were inconclusive. More research is warranted to better understand where delays occur and factors which may influence this for both FEP and CHR-P populations which may help to develop targeted interventions to address delays.
摘要：
目的：临床精神病高危人群（CHR-P）和首发精神病患者（FEP）中，未治疗精神病（DUP）持续时间过长和未治疗疾病（DUI）持续时间过长与预后较差相关。然而,患有FEP的人通常会遇到涉及与警察接触的负面护理途径，危机服务并要求强制入学，有证据表明，FEP和CHR-P患者通常会长期延迟治疗。早期检测干预措施，如公共卫生干预，可能是减少延误的一种方法。本系统综述旨在综合此类干预措施的现有证据。
方法：EMBASE，心理信息,CINAHL,和MEDLINE数据库进行了搜索。如果将旨在改善FEP或CHR-P患者及时获得治疗的干预措施与标准治疗提供进行比较，则纳入研究。干预措施可能针对潜在患者，他们的家人,广大市民,或非医疗保健专业人员。感兴趣的结果是DUP或DUI，和/或护理途径的特征。
结果：19项研究符合纳入标准。全部由FEP人群组成，没有CHR-P人群。采用叙事综合，我们发现,干预措施在降低DUP方面的效果好坏参半,且干预措施似乎对各组产生不同影响.获得护理信息的途径有限且混杂。
结论：关于旨在改善及时获得治疗的干预措施的有效性的结果尚无定论。有必要进行更多的研究，以更好地了解FEP和CHR-P人群的延误发生地点以及可能影响延误的因素，这可能有助于制定有针对性的干预措施来解决延误问题。
方法：EMBASE，心理信息,CINAHL,和MEDLINE数据库进行了搜索。如果将旨在改善FEP或CHR-P患者及时获得治疗的干预措施与标准治疗提供进行比较，则纳入研究。干预措施可能针对潜在患者，他们的家人,广大市民,或非医疗保健专业人员。感兴趣的结果是DUP或DUI，和/或护理途径的特征。
结果：19项研究符合纳入标准。全部由FEP人群组成，没有CHR-P人群。采用叙事综合，我们发现,干预措施在降低DUP方面的效果好坏参半,且干预措施似乎对各组产生不同影响.获得护理信息的途径有限且混杂。
结论：关于旨在改善及时获得治疗的干预措施的有效性的结果尚无定论。有必要进行更多的研究，以更好地了解FEP和CHR-P人群的延误发生地点以及可能影响延误的因素，这可能有助于制定有针对性的干预措施来解决延误问题。
