Detection of psychosis by mental health care services; a naturalistic cohort study

Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic sympt...
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Autor*in:	Boonstra, Nynke [verfasserIn] Wunderink, Lex Sytema, Sjoerd Wiersma, Durk

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2008

Schlagwörter:	Mental Health Service Psychotic Symptom Personality Disorder Antipsychotic Medication Psychotic Disorder

Anmerkung:	© Boonstra et al; licensee BioMed Central Ltd. 2008

Übergeordnetes Werk:	Enthalten in: Clinical practice and epidemiology in mental health - London : BioMed Central, 2005, 4(2008), 1 vom: 16. Dez.
Übergeordnetes Werk:	volume:4 ; year:2008 ; number:1 ; day:16 ; month:12

Links:	Volltext

DOI / URN:	10.1186/1745-0179-4-29

Katalog-ID:	SPR029346649

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520			\|a Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis.
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allfields	10.1186/1745-0179-4-29 doi (DE-627)SPR029346649 (SPR)1745-0179-4-29-e DE-627 ger DE-627 rakwb eng Boonstra, Nynke verfasserin aut Detection of psychosis by mental health care services; a naturalistic cohort study 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Boonstra et al; licensee BioMed Central Ltd. 2008 Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. Mental Health Service (dpeaa)DE-He213 Psychotic Symptom (dpeaa)DE-He213 Personality Disorder (dpeaa)DE-He213 Antipsychotic Medication (dpeaa)DE-He213 Psychotic Disorder (dpeaa)DE-He213 Wunderink, Lex aut Sytema, Sjoerd aut Wiersma, Durk aut Enthalten in Clinical practice and epidemiology in mental health London : BioMed Central, 2005 4(2008), 1 vom: 16. Dez. (DE-627)629840423 (DE-600)2559748-6 1745-0179 nnns volume:4 year:2008 number:1 day:16 month:12 https://dx.doi.org/10.1186/1745-0179-4-29 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2008 1 16 12
spelling	10.1186/1745-0179-4-29 doi (DE-627)SPR029346649 (SPR)1745-0179-4-29-e DE-627 ger DE-627 rakwb eng Boonstra, Nynke verfasserin aut Detection of psychosis by mental health care services; a naturalistic cohort study 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Boonstra et al; licensee BioMed Central Ltd. 2008 Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. Mental Health Service (dpeaa)DE-He213 Psychotic Symptom (dpeaa)DE-He213 Personality Disorder (dpeaa)DE-He213 Antipsychotic Medication (dpeaa)DE-He213 Psychotic Disorder (dpeaa)DE-He213 Wunderink, Lex aut Sytema, Sjoerd aut Wiersma, Durk aut Enthalten in Clinical practice and epidemiology in mental health London : BioMed Central, 2005 4(2008), 1 vom: 16. Dez. (DE-627)629840423 (DE-600)2559748-6 1745-0179 nnns volume:4 year:2008 number:1 day:16 month:12 https://dx.doi.org/10.1186/1745-0179-4-29 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2008 1 16 12
allfields_unstemmed	10.1186/1745-0179-4-29 doi (DE-627)SPR029346649 (SPR)1745-0179-4-29-e DE-627 ger DE-627 rakwb eng Boonstra, Nynke verfasserin aut Detection of psychosis by mental health care services; a naturalistic cohort study 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Boonstra et al; licensee BioMed Central Ltd. 2008 Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. Mental Health Service (dpeaa)DE-He213 Psychotic Symptom (dpeaa)DE-He213 Personality Disorder (dpeaa)DE-He213 Antipsychotic Medication (dpeaa)DE-He213 Psychotic Disorder (dpeaa)DE-He213 Wunderink, Lex aut Sytema, Sjoerd aut Wiersma, Durk aut Enthalten in Clinical practice and epidemiology in mental health London : BioMed Central, 2005 4(2008), 1 vom: 16. Dez. (DE-627)629840423 (DE-600)2559748-6 1745-0179 nnns volume:4 year:2008 number:1 day:16 month:12 https://dx.doi.org/10.1186/1745-0179-4-29 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2008 1 16 12
allfieldsGer	10.1186/1745-0179-4-29 doi (DE-627)SPR029346649 (SPR)1745-0179-4-29-e DE-627 ger DE-627 rakwb eng Boonstra, Nynke verfasserin aut Detection of psychosis by mental health care services; a naturalistic cohort study 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Boonstra et al; licensee BioMed Central Ltd. 2008 Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. Mental Health Service (dpeaa)DE-He213 Psychotic Symptom (dpeaa)DE-He213 Personality Disorder (dpeaa)DE-He213 Antipsychotic Medication (dpeaa)DE-He213 Psychotic Disorder (dpeaa)DE-He213 Wunderink, Lex aut Sytema, Sjoerd aut Wiersma, Durk aut Enthalten in Clinical practice and epidemiology in mental health London : BioMed Central, 2005 4(2008), 1 vom: 16. Dez. (DE-627)629840423 (DE-600)2559748-6 1745-0179 nnns volume:4 year:2008 number:1 day:16 month:12 https://dx.doi.org/10.1186/1745-0179-4-29 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2008 1 16 12
allfieldsSound	10.1186/1745-0179-4-29 doi (DE-627)SPR029346649 (SPR)1745-0179-4-29-e DE-627 ger DE-627 rakwb eng Boonstra, Nynke verfasserin aut Detection of psychosis by mental health care services; a naturalistic cohort study 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Boonstra et al; licensee BioMed Central Ltd. 2008 Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. Mental Health Service (dpeaa)DE-He213 Psychotic Symptom (dpeaa)DE-He213 Personality Disorder (dpeaa)DE-He213 Antipsychotic Medication (dpeaa)DE-He213 Psychotic Disorder (dpeaa)DE-He213 Wunderink, Lex aut Sytema, Sjoerd aut Wiersma, Durk aut Enthalten in Clinical practice and epidemiology in mental health London : BioMed Central, 2005 4(2008), 1 vom: 16. Dez. (DE-627)629840423 (DE-600)2559748-6 1745-0179 nnns volume:4 year:2008 number:1 day:16 month:12 https://dx.doi.org/10.1186/1745-0179-4-29 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2008 1 16 12
language	English
source	Enthalten in Clinical practice and epidemiology in mental health 4(2008), 1 vom: 16. Dez. volume:4 year:2008 number:1 day:16 month:12
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authorswithroles_txt_mv	Boonstra, Nynke @@aut@@ Wunderink, Lex @@aut@@ Sytema, Sjoerd @@aut@@ Wiersma, Durk @@aut@@
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Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. 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author	Boonstra, Nynke
spellingShingle	Boonstra, Nynke misc Mental Health Service misc Psychotic Symptom misc Personality Disorder misc Antipsychotic Medication misc Psychotic Disorder Detection of psychosis by mental health care services; a naturalistic cohort study
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topic_title	Detection of psychosis by mental health care services; a naturalistic cohort study Mental Health Service (dpeaa)DE-He213 Psychotic Symptom (dpeaa)DE-He213 Personality Disorder (dpeaa)DE-He213 Antipsychotic Medication (dpeaa)DE-He213 Psychotic Disorder (dpeaa)DE-He213
topic	misc Mental Health Service misc Psychotic Symptom misc Personality Disorder misc Antipsychotic Medication misc Psychotic Disorder
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title	Detection of psychosis by mental health care services; a naturalistic cohort study
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title_full	Detection of psychosis by mental health care services; a naturalistic cohort study
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title_sort	detection of psychosis by mental health care services; a naturalistic cohort study
title_auth	Detection of psychosis by mental health care services; a naturalistic cohort study
abstract	Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. © Boonstra et al; licensee BioMed Central Ltd. 2008
abstractGer	Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. © Boonstra et al; licensee BioMed Central Ltd. 2008
abstract_unstemmed	Background Detection of psychotic disorders is an important issue, since early treatment might improve prognosis. Timely diagnosis of psychotic disorders depends on recognition of psychotic symptoms and their interpretation. The aim of this study is to examine to what extent reported psychotic symptoms are accounted for in clinical diagnosis. Methods The medical files of all patients who had a first contact with one of two mental health care services (N = 6477) were screened for reported psychotic symptoms and subsequent clinical diagnosis. Patients who reported psychotic symptoms and who were diagnosed with a psychotic disorder were followed-up for two years to register prescription of antipsychotic treatment and continuity of care. Results In the files of 242 (3.7%) patients specific psychotic symptoms were recorded. 37% of these patients were diagnosed with a non-affective psychotic disorder, 7% with other psychotic disorders and 56% with non-psychotic disorders or no diagnosis at all. About 90% of the patients diagnosed with a psychotic disorder did receive any prescription of antipsychotics, and about 50% were in continuous care during the first 2 years. Conclusion Relatively large proportions of patients presenting with psychotic symptoms were diagnosed with a non-psychotic diagnosis or not diagnosed at all. This applies also to patients reporting at least two or more psychotic symptoms. Although we did not verify the appropriateness of clinical diagnosis, these findings are an indication that psychotic disorders may be underdetected. Improving the diagnostic process in mental health care services may be the most obvious way to promote early intervention in psychosis. © Boonstra et al; licensee BioMed Central Ltd. 2008
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title_short	Detection of psychosis by mental health care services; a naturalistic cohort study
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Detection of psychosis by mental health care services; a naturalistic cohort study

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