A brief questionnaire can ensure that more psychoses are recognized at an early stage. Everyone who registers at a mental healthcare centre (GGZ) should complete this questionnaire. This is extremely important because the earlier a psychosis is recognized and treated, the more favourable the prognosis. This has been revealed by research by UMCG researcher Nynke Boonstra. On 10 November, at a ceremony in Franeker, Nynke Boonstra will be awarded a PhD by the University of Groningen for the results of her research.
She has demonstrated that intake staff at GGZ centres too frequently fail to recognize psychotic disorders. The result is that the centres contribute 30% of the total time that a psychosis remains untreated. Boonstra recommends the questionnaire being introduced to systematically trace psychotic symptoms.
Early treatment of a psychosis turns out to have a favourable effect on the prognosis. Boonstra has demonstrated in her research that patients who are treated for their psychosis within 9 months of it occurring develop less serious negative symptoms in both the short and the long term. The quicker the treatment starts, the better. Boonstra therefore recommends keeping the duration of an untreated psychosis as short as possible. About 30% of patients have an untreated psychosis for more than 9 months. Important improvements in the prognosis are definitely possible in this group.
Many factors can influence when the treatment begins. They include the time it takes before the patient seeks help, the time it takes to recognize a psychosis and refer the patient on to a specialized GGZ centre, and the time it takes to start up the treatment. Boonstra had expected the GGZ centres to be good at recognizing the symptoms of a psychosis and thus barely contribute to the time a psychosis remains untreated, but the data revealed that GGZ centres are responsible for 30% of the total time that a psychosis remains untreated. The delays were the longest for patients whose psychosis started while they were being treated by the GGZ centre. She suspects that this is due to a lack of diagnoses being revised.
Boonstra has established that if all patients who report to a GGZ centre complete a self-report questionnaire, this may contribute to a quicker recognition of psychoses. In a group of 246 patients who were thoroughly investigated, Boonstra could determine that 26 had psychotic disorders. Only 10 of them (38%) had been recognized as such by the treatment provider, whereas with the questionnaire alongside, another 14 of the 16 remaining patients were detected. Boonstra concludes that systematic use of the standardized questionnaire is a relatively simple way of improving the detection of psychotic patients.
Nynke Boonstra (Leeuwarden, 1975) studied Health Sciences at the University of Maastricht. She works for GGZ Friesland, currently as a researcher and trainer of GGZ nursing specialists. She conducted her research in a cooperation among GGZ Friesland, the University Center for Psychiatry of the UMCG, the department of Psychiatry of the AMC and Mediant Twente. Her thesis is entitled ‘Early detection of psychoses; why should we care?’ Her PhD ceremony will be held in the Martinikerk in Franeker on November 10th.
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