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First Episode Psychosis Egypt
 

First Episode Psychosis Egypt

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    First Episode Psychosis Egypt First Episode Psychosis Egypt Presentation Transcript

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