Nearly 40% of young people with newly diagnosed schizophrenia do not receive any physician follow-up
Young Ontarians being diagnosed for the first time with schizophrenia are not receiving adequate physician follow-up, according to a new study from the Institute for Clinical Evaluative Sciences (ICES).
The researchers identified all Ontario residents aged 14 to 35 years who received a first diagnosis of schizophrenia or schizoaffective disorder between 1999 and 2008. Of the 20,096 people with a first diagnosis of schizophrenia, approximately 40 per cent of them did not receive any physician follow-up within 30 days, and nearly 60 per cent did not receive follow-up by a psychiatrist.
“Receiving a first psychotic disorder diagnosis can be both scary and overwhelming for young people. Physician follow-up after the first diagnosis is crucial for giving young people the support they need to achieve good treatment outcomes. The lack of follow-up is of tremendous concern,” says Dr. Paul Kurdyak, co-author, ICES scientist and chief, division of general and health systems psychiatry, at CAMH.
The study was published today in the Canadian Journal of Psychiatry.
Current Ontario standards dictate that patients should ideally be followed-up by a mental health professional within 72 hours of the first identification of a psychotic disorder.
“Our findings suggest that many people do not have any physician contact within 30-days of the first diagnosis of schizophrenia, and patients without prior engagement with mental health services are at the highest risk,” says Dr. Kelly Anderson, lead author on the study, assistant professor in the Department of Epidemiology & Biostatistics at Western University and an epidemiologist at ICES Western.
The researchers also found:
- Males had lower odds of receiving any physician follow-up.
- The odds of psychiatrist follow-up decreased with increasing age and were lower for those living in rural areas.
- Previous contact with a psychiatrist or a general practitioner for a mental health reason was strongly associated with higher odds of receiving follow-up.
“We need information on the reasons behind this lack of physician follow-up to inform strategies aimed at improving engagement with services during the early stages of psychosis,” adds Anderson.
“Factors associated with timely physician follow-up after a first diagnosis of psychotic disorder” was published today in the Canadian Journal of Psychiatry.
Author block: Kelly K. Anderson and Paul Kurdyak.
The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario
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