The duration of untreated psychosis: a phenomenological study

ABSTRACT

Mounting evidence has indicated that early intervention leads to improved clinical and functional outcomes for young persons experiencing recent onset psychosis. As part of a large early detection campaign, the present study aimed to investigate subjective experiences during the duration of untreated psychosis (DUP), or time between psychosis onset and treatment contact. Participants were 10 young adults participating in early intervention services for psychosis. After DUP was estimated during standardized baseline assessment, participants engaged in qualitative interviews focused on their life experiences prior to treatment and leading up to the present. Mixed methods data analyses compared standardized DUP estimates with participants’ subjective narratives. Findings revealed that participants experienced and conceptualized a longer trajectory of subjective difficulties (TSD) beginning before and extending beyond standardized DUP estimates. Participants emphasized striving for independence and social belonging. The majority of participants reported benefiting from their current services and believed that earlier support of some kind would have been beneficial. These findings support previous research on subjective barriers to early detection and treatment seeking in young adults experiencing psychosis. Implications and future research directions include further efforts to differentiate the struggles unique to early psychosis from psychosocial risk factors and other challenges of young adulthood.

KEYWORDS:

• Early intervention
• duration of untreated psychosis
• first episode psychosis
• phenomenology
• transition-age youth

Acknowledgments

The authors are grateful for the invaluable expertise of the consultant whose insights shaped the interview protocol, the generous time and dedication of Philip Markovich and Shadie Burke, and the input of members STEP-PRIME Works in Progress seminar series. We are also grateful to Wesleyan University students Taylor Dillon, Hannah Bolotin, Neha Srinivas and Alexandra Riedel for their assistance with the literature review and insights about the project.

Disclosure statement

The trial is registered at ClinicalTrials.gov (NCT02069925). This publication does not express the views of the Department of Mental Health and Addiction Services or the State of Connecticut. The views and opinions expressed are those of the authors. The authors report no conflict of interest.

Notes

1. All names have been changed to protect participants’ privacy.

Additional information

Funding

This work was supported by a grant to Dr. Srihari, principal investigator, from the National Institutes of Health (MH103831) and in part by the State of Connecticut, Department of Mental Health and Addiction Services.