Schizophrenia is a serious mental illness, and research shows that the longer patients and their families wait to seek treatment the more debilitating the disease can become. Emory researchers at Grady Memorial Hospital are now studying what causes individuals and families to delay treatment after the onset of symptoms of schizophrenia. The researchers hope their results will be used to better understand how treatment delays can be reduced by raising awareness of the disease, and thereby reducing societal stigma and other barriers to early treatment.
The ACES project, or the Atlanta Cohort on the Early course of schizophrenia, is being led by Michael T. Compton, MD, MPH, assistant professor in the Department of Psychiatry and Behavioral Sciences at the Emory University School of Medicine. The five-year project is funded by a K award, or career development grant from the National Institute of Mental Health.
"Research has shown fairly consistently that in the case of early schizophrenia, the longer you wait before you seek treatment, the worse your outcomes are over the first few years of the illness," says Dr. Compton, the study's principal investigator. "Some patients may delay treatment for only a couple of weeks and others may delay treatment for several years."
Dr. Compton says the ACES project will help researchers understand what accounts for how long patients and families wait from the onset of psychotic symptoms until the time of hospital admission.
Schizophrenia affects approximately 1 percent of the population over the course of a lifetime. Symptoms usually become apparent between the ages of 18 to 28. The disease is associated with a variety of symptoms, including auditory hallucinations and delusions, social isolation and diminished drive, as well as subtle cognitive symptoms like disruptions in attention and memory.
As part of the project, Dr. Compton and other researchers interview patients between the ages of 18 and 40 who present at Grady Hospital and DeKalb Crisis Center with a schizophrenia-related illness. They also assess patients' family members. Relatives typically bring patients to the hospital rather than the patients themselves, and the relatives therefore provide a window into the patients' early disease course.
Researchers examine family strengths and family coping mechanisms; beliefs about what causes schizophrenia; general level of knowledge about the disease; and health insurance status to determine if these factors are correlated with how long patients and their families wait to seek treatment.
So far, 36 patients have been assessed with a first episode of a schizophrenia-spectrum disorder. Researchers are now implementing a qualitative component in which they will interview family members to further study determinants of the duration of treated psychosis (DUP) or treatment delay in the early course of schizophrenia.
"If treatment delay is related to lack of knowledge about the symptoms and perceived stigma in the community, for example, then we need to develop public education campaigns about the early signs of schizophrenia in order to raise knowledge and decrease stigma," Dr. Compton says. "Someday we might see a better outcome for the disease because patients are coming into treatment earlier."