Duration of Untreated Psychosis

Despite the recognition that duration of untreated psychosis (DUP) is a strong predictor of clinical and functional outcomes, DUP in the United States remains far outside the recommended range. Specialty first episode psychosis (FEP) programs such as the EDAPT (Early Diagnosis and Preventive Treatment) Program in Sacramento have become more common in the U.S. in recent years and represent an important step toward improving outcomes for young people with psychosis. However, within the context of FEP specialty care, standard approaches to outreach, screening and treatment engagement continue to be associated with unacceptably long DUP.

In this NIMH-funded study we will test the hypotheses that the systematic use of innovative, technology-based screening (at primary health care, emergency room/inpatient hospitals, school-based and community mental health settings), and mobile engagement treatment approaches, within a well-established community-wide specialty FEP service, will significantly reduce DUP. DUP is defined for this proposal as time from psychosis onset determined by clinical interview to engagement in FEP specialty care.

Successful completion of our aims will provide a new set of evidence based tools and practices to enhance early identification and engagement of FEP patients in specialty care, in order to reduce DUP and improve long-term clinical and functional outcomes for these young people. In addition to reducing DUP, the screening strategies we will test are consistent with recent federal proposals to improve school-based screening for mental health problems (e.g. Mental Health in Schools Act).

Principal Investigators: Cameron Carter, M.D., Tara Niendam, Ph.D., Daniel Ragland, Ph.D., Rachel Lowey, Ph.D., Rosemary Cress, Ph.D., Peter Yellowlees, M.D., Kevin Delucchi, Ph.D.

Personnel: Tyler Lesh, Ph.D., Howard Goldman, M.D., Ph.D., Rachel Suk, B.S., Sarah Gobrial, B.S., Natalia Lara Gonzalez, B.A.