Examining evidence for neighbourhood variation in the duration of untreated psychosis

BACKGROUND: Family involvement in help-seeking is associated with a shorter duration of untreated psychoses [DUP], but it is unknown whether neighbourhood-level factors are also important. METHODS: DUP was estimated for all cases of first-episode psychoses identified over 2 years in 33 Southeast Lon...

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Autores principales: Kirkbride, J.B., Lunn, D.J., Morgan, C., Lappin, J.M., Dazzan, P., Morgan, K., Fearon, P., Murray, R.M., Jones, P.B.
Formato: Texto
Lenguaje:English
Publicado: Elsevier 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812704/
https://www.ncbi.nlm.nih.gov/pubmed/19875323
http://dx.doi.org/10.1016/j.healthplace.2009.09.013
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author Kirkbride, J.B.
Lunn, D.J.
Morgan, C.
Lappin, J.M.
Dazzan, P.
Morgan, K.
Fearon, P.
Murray, R.M.
Jones, P.B.
author_facet Kirkbride, J.B.
Lunn, D.J.
Morgan, C.
Lappin, J.M.
Dazzan, P.
Morgan, K.
Fearon, P.
Murray, R.M.
Jones, P.B.
author_sort Kirkbride, J.B.
collection PubMed
description BACKGROUND: Family involvement in help-seeking is associated with a shorter duration of untreated psychoses [DUP], but it is unknown whether neighbourhood-level factors are also important. METHODS: DUP was estimated for all cases of first-episode psychoses identified over 2 years in 33 Southeast London neighbourhoods (n=329). DUP was positively skewed and transformed to the natural logarithm scale. We fitted various hierarchical models, adopting different assumptions with regard to spatial variability of DUP, to assess whether there was evidence of neighbourhood heterogeneity in DUP, having accounted for a priori individual-level confounders. RESULTS: Neighbourhood-level variation in DUP was negligible compared to overall variability. A non-hierarchical model with age, sex and ethnicity covariates, but without area-level random effects, provided the best fit to the data. DISCUSSION: Neighbourhood factors do not appear to be associated with DUP, suggesting its predictors lie at individual and family levels. Our results inform mental healthcare planning, suggesting that in one urbanised area of Southeast London, where you live does not affect duration of untreated psychosis.
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spelling pubmed-28127042010-01-28 Examining evidence for neighbourhood variation in the duration of untreated psychosis Kirkbride, J.B. Lunn, D.J. Morgan, C. Lappin, J.M. Dazzan, P. Morgan, K. Fearon, P. Murray, R.M. Jones, P.B. Health Place Article BACKGROUND: Family involvement in help-seeking is associated with a shorter duration of untreated psychoses [DUP], but it is unknown whether neighbourhood-level factors are also important. METHODS: DUP was estimated for all cases of first-episode psychoses identified over 2 years in 33 Southeast London neighbourhoods (n=329). DUP was positively skewed and transformed to the natural logarithm scale. We fitted various hierarchical models, adopting different assumptions with regard to spatial variability of DUP, to assess whether there was evidence of neighbourhood heterogeneity in DUP, having accounted for a priori individual-level confounders. RESULTS: Neighbourhood-level variation in DUP was negligible compared to overall variability. A non-hierarchical model with age, sex and ethnicity covariates, but without area-level random effects, provided the best fit to the data. DISCUSSION: Neighbourhood factors do not appear to be associated with DUP, suggesting its predictors lie at individual and family levels. Our results inform mental healthcare planning, suggesting that in one urbanised area of Southeast London, where you live does not affect duration of untreated psychosis. Elsevier 2010-03 /pmc/articles/PMC2812704/ /pubmed/19875323 http://dx.doi.org/10.1016/j.healthplace.2009.09.013 Text en © 2010 Elsevier Ltd. https://creativecommons.org/licenses/by/3.0/ Open Access under CC BY 3.0 (https://creativecommons.org/licenses/by/3.0/) license
spellingShingle Article
Kirkbride, J.B.
Lunn, D.J.
Morgan, C.
Lappin, J.M.
Dazzan, P.
Morgan, K.
Fearon, P.
Murray, R.M.
Jones, P.B.
Examining evidence for neighbourhood variation in the duration of untreated psychosis
title Examining evidence for neighbourhood variation in the duration of untreated psychosis
title_full Examining evidence for neighbourhood variation in the duration of untreated psychosis
title_fullStr Examining evidence for neighbourhood variation in the duration of untreated psychosis
title_full_unstemmed Examining evidence for neighbourhood variation in the duration of untreated psychosis
title_short Examining evidence for neighbourhood variation in the duration of untreated psychosis
title_sort examining evidence for neighbourhood variation in the duration of untreated psychosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812704/
https://www.ncbi.nlm.nih.gov/pubmed/19875323
http://dx.doi.org/10.1016/j.healthplace.2009.09.013
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