First Episode Psychosis: Factors associated with delayed access to care in a rural Egyptian setting <ul><li>Dr Mamdouh EL-...
Aim: <ul><li>To identify factors associated with delayed access of individuals diagnosed with First Episode Psychosis (FEP...
Background: <ul><li>FEP:  Growing interest over past few decades. </li></ul><ul><li>DUP:-  Duration of Untreated Psychosis...
Method: <ul><li>Study sample:  FEP. </li></ul><ul><li>Study period:  6 months. </li></ul><ul><li>Study centre:  Psychiatri...
 
Mansoura City: <ul><li>Established 1219  </li></ul><ul><li>By King AL-Saleh Ayoub during his combat against the Crusades. ...
Service Model <ul><li>Primary care : underdeveloped. </li></ul><ul><li>Specialist care :  </li></ul><ul><li>- MGH.: Psych ...
Psychiatric Dept. at MGH <ul><li>Catchment area:  one million. </li></ul><ul><li>Inpatient:  8 beds. </li></ul><ul><li>OPC...
Results <ul><li>Total number of cases:  40 </li></ul><ul><li>Diagnosis:  - Schizophrenia: 14 </li></ul><ul><li>- Affective...
Diagnostic Categories
Gender & Geographical area
Gender & Age Groups
DUP -  No Gender difference in the Egyptian study .
Factors associated with delayed  access
Cultural Factors
Referral Sources
Conclusion <ul><li>Cultural factors, Lack of knowledge, Stigma & financial factors may play a significant role in delayed ...
Clinical implications <ul><li>Public education & anti-stigma programmes are needed. </li></ul><ul><li>Early Intervention i...
Limitations <ul><li>Sample size : small. </li></ul><ul><li>Service model : does not guarantee that all cases within the ca...
Acknowledgment <ul><li>Thanks to our patients & their families who were extremely helpful and agreed to participate in thi...
Thank You
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First Episode Psychosis Egypt

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First Episode Psychosis Egypt

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First Episode Psychosis Egypt

  1. 1. First Episode Psychosis: Factors associated with delayed access to care in a rural Egyptian setting <ul><li>Dr Mamdouh EL-Adl, Princess Marina Hospital, Northampton, UK. </li></ul><ul><li>Dr Mohammed EL-Mahdy, AL-Azhar University, Egypt. </li></ul><ul><li>Dr Musheera Anis, Mansoura General Hospital, Egypt. </li></ul>
  2. 2. Aim: <ul><li>To identify factors associated with delayed access of individuals diagnosed with First Episode Psychosis (FEP) to Psychiatric Care. </li></ul>
  3. 3. Background: <ul><li>FEP: Growing interest over past few decades. </li></ul><ul><li>DUP:- Duration of Untreated Psychosis. </li></ul><ul><li>- Average: one year or more (McGlashan,1998). </li></ul><ul><li>- Long DUP: undesirable. </li></ul><ul><li>Early Treatment: </li></ul><ul><li>- Reduces suffering (Ho et al, 2003). </li></ul><ul><li>- Minimises risks (Larsen et al,1998; Wyatt et al, 1998). </li></ul>
  4. 4. Method: <ul><li>Study sample: FEP. </li></ul><ul><li>Study period: 6 months. </li></ul><ul><li>Study centre: Psychiatric Dept., MGH. </li></ul><ul><li>Study team: Drs EL-Adl, EL-Mahdy & Anis. </li></ul><ul><li>Study tool: A semi-structured interview. </li></ul><ul><li>FEP cases & relevant others were interviewed. </li></ul>
  5. 6. Mansoura City: <ul><li>Established 1219 </li></ul><ul><li>By King AL-Saleh Ayoub during his combat against the Crusades. </li></ul><ul><li>Capital of Eldakahlia province. </li></ul><ul><li>Surrounded by a large rural area. </li></ul><ul><li>Population: - Mansoura: 2 millions. </li></ul><ul><li>- Eldakahlia: 5 millions. </li></ul>
  6. 7. Service Model <ul><li>Primary care : underdeveloped. </li></ul><ul><li>Specialist care : </li></ul><ul><li>- MGH.: Psych dept. </li></ul><ul><li>- MUHs.: Psych dept. </li></ul><ul><li>- Central hospitals.: No Psych. Dept. </li></ul><ul><li>Mental Health Service : Hospital based. </li></ul>
  7. 8. Psychiatric Dept. at MGH <ul><li>Catchment area: one million. </li></ul><ul><li>Inpatient: 8 beds. </li></ul><ul><li>OPC: 100 patients/day. </li></ul><ul><li>Staff: </li></ul><ul><li>- Psychiatrists: 2 SHO, 8 Specialists, 2 Consultants. </li></ul><ul><li>- Psychiatric Nurses: 8 </li></ul><ul><li>- Psychologist: 1 </li></ul><ul><li>- Social Worker: 1 </li></ul>
  8. 9. Results <ul><li>Total number of cases: 40 </li></ul><ul><li>Diagnosis: - Schizophrenia: 14 </li></ul><ul><li>- Affective disorders: 16 </li></ul><ul><li>- Postpartum disorders: 5 </li></ul><ul><li>- Others: 5 </li></ul>
  9. 10. Diagnostic Categories
  10. 11. Gender & Geographical area
  11. 12. Gender & Age Groups
  12. 13. DUP - No Gender difference in the Egyptian study .
  13. 14. Factors associated with delayed access
  14. 15. Cultural Factors
  15. 16. Referral Sources
  16. 17. Conclusion <ul><li>Cultural factors, Lack of knowledge, Stigma & financial factors may play a significant role in delayed access to care. </li></ul><ul><li>Public education & anti-stigma programmes are needed. </li></ul><ul><li>A community oriented MH service is important. </li></ul><ul><li>Integration between Primary & Secondary care is essential. </li></ul>
  17. 18. Clinical implications <ul><li>Public education & anti-stigma programmes are needed. </li></ul><ul><li>Early Intervention in Psychosis has to be promoted. </li></ul><ul><li>Exchange of experience & collaborative research between Arab Psychiatrists in home countries & abroad should be promoted. </li></ul>
  18. 19. Limitations <ul><li>Sample size : small. </li></ul><ul><li>Service model : does not guarantee that all cases within the catchment’s area are included. </li></ul><ul><li>Study results : may not apply to other areas in Egypt or other Arab countries. </li></ul>
  19. 20. Acknowledgment <ul><li>Thanks to our patients & their families who were extremely helpful and agreed to participate in this study. </li></ul>
  20. 21. Thank You

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