[Pathway to care of people with first episode of schizophrenia, in Chile].

Rev Fac Cien Med Univ Nac Cordoba

Instituto de Salud Poblacional "Escuela de Salud Pública Dr. Salvador Allende", Facultad de Medicina, Universidad de Chile.

Published: January 2017

Background: It has been considered that the duration of first episode of psychosis is a critical period influencing the clini-cal and psychosocial evolution in people with diagnosis of schizophrenia. However, there is little knowledge about this issue in Low and Middle Income Countries.

Objective: To describe the clinical characteristics and contacts with health services of people with first episode of schizophrenia, prior to their diagnoses and initiation of treatment. Sources and methods. The sample included all persons with diagnosis of first episode of schizo-phrenia, in five psychiatric care centers, located in the North, Center and South of Chile. Diagnosis was confirmed with ICD-10 criteria and psychopathology symptoms were explored using PANSS.

Results: The sample was constituted by 48 patients (79.2% men, average age in 23.4 years). The symptom of depression was the first to appear (me-dian of 15 months, before diagnosis). Positive symptoms started in the previous year before diagnosis (delusions, median of 6 months). Positive symptoms triggered the first contact in 77.1% of the patients. Of these cases, 91.7% had medical care in this period (in Primary Health Care Centers and Mental Health Centers). The me-dian for previous contacts was 3.5, but the correct diagnosis was not done at that time.

Conclusion: Most of the patients had medical contacts for their psychotic symptoms, but their diagnosis were not made within that period, delaying the start of treatment. There is a need to develop strategies to improve diagnosis capabilities in these centers.

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