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Venkataraman S, Hazan H, Li F, Ferrara M, Harper A, Ma J, Shah J, Musket C, Levine N, Keshavan MS, Srihari V. Role of Early Psychosis Detection in the Relationship Between Personal Income and Duration of Untreated Psychosis. Psychiatr Serv 2024; 75:427-433. [PMID: 38204369 DOI: 10.1176/appi.ps.20230239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Prolonged duration of untreated psychosis (DUP) predicts poor outcomes of first-episode psychosis (FEP) and is often linked to low socioeconomic status (SES). The authors sought to determine whether patients' personal income, used as a proxy for SES, predicts length of DUP and whether personal income influences the effect of an early psychosis detection campaign-called Mindmap-on DUP reduction. METHODS Data were drawn from a trial that compared the effectiveness of early detection in reducing DUP across the catchment area of an FEP service (N=147 participants) compared with an FEP service with no early detection (N=75 participants). Hierarchical regression was used to determine whether personal income predicted DUP when analyses controlled for effects of age, race, and exposure to early psychosis detection. A group × personal income interaction term was used to assess whether the DUP difference between the early detection and control groups differed by personal income. RESULTS Lower personal income was significantly associated with younger age, fewer years of education, Black race, and longer DUP. Personal income predicted DUP beyond the effects of age, race, and early psychosis detection. Although Mindmap significantly reduced DUP across all income levels, this effect was smaller for participants reporting lower personal income. CONCLUSIONS Patients' personal income may be an important indicator of disparity in access to specialty care clinics across a wide range of settings. Early detection efforts should measure and target personal income and other SES indicators to improve access for all individuals who may benefit from FEP services.
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Affiliation(s)
- Shruthi Venkataraman
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Hadar Hazan
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Fangyong Li
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Maria Ferrara
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Annie Harper
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Jessica Ma
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Jai Shah
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Christie Musket
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Nina Levine
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Matcheri S Keshavan
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
| | - Vinod Srihari
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal (Venkataraman); Department of Psychiatry, Program for Specialized Treatment Early in Psychosis, Yale University School of Medicine, New Haven (Hazan, Ferrara, Musket, Levine, Srihari); Yale Center for Analytical Sciences, Yale School of Public Health, New Haven (Li); Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy (Ferrara); Department of Psychiatry, McGill University, Montreal (Harper, Shah); Center for Brain Health, School of Brain and Behavioral Science, University of Texas at Dallas, Dallas (Ma); Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven (Musket); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston (Keshavan)
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