Effects on referral patterns of reducing intensive informational campaigns about first-episode psychosis

Aim: The primary aim of this study was to assess referral patterns and duration of untreated psychosis (DUP) following the partial dismantling of intensive, information campaigns (IC) to help detect first-episode, non-affective psychosis via early detection teams in the TIPS study. Methods: We compared referral patterns of potential cases from the same geographical region (Rogaland County, Norway) referred to low-threshold, rapid-response detection teams at three timepoints: early-IC period (1997-1998), late-IC period (1999-2000) and the no-IC period (2002-2003). Results: A significant increase occurred in the total number of phone calls, Positive and Negative Syndrome Scale (PANSS)-interviews and referrals from families from the early-to the late-IC period. A comparison of the late-IC period versus no-IC period showed a significant decrease in the number of PANSS-interviews administered, as well as fewer cases referred to the assessment teams. Additionally, a significant decline occurred in the number of referrals from general physicians, whereas the number of direct referrals to the hospital units increased. The DUP increased from a median of 5 to 14 weeks. Conclusion: External referrals to easy access detection teams occurred more frequently when IC were intensive, especially referrals from families and general practitioners. A shorter DUP was observed in the IC period, suggesting the importance of IC in augmenting the effectiveness of detection teams in identifying first-episode psychosis early in the course of illness.