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Journal article : Review

Identifying individuals at risk of developing psychosis: A systematic review of the literature in primary care services

Abstract:
Aim Psychosis and related disorders are a major public health issue. Early identification and prevention for those at high risk (at-risk-mental-state, ARMS) is important. General practitioners (GPs) are often the first point of contact for health services. In this review we aim to identify (1) the most common methods for identifying individuals with an ARMS in primary care, (2) the methods for improving identification of individuals with an ARMS in primary care, and (3) the most common barriers that prevent GPs from screening for individuals with an ARMS. Methods We conducted a systematic review (PROSPERO 42021245095) of quantitative and qualitative studies with no date restriction. Searches were performed in September 2021. Studies' quality was appraised using Mixed Methods Appraisal tool (MMAT). Results We identified 16 eligible studies, and all but one provided quantitative data. Nearly two-thirds of studies were classified as ‘medium’ quality. Employing narrative synthesis, we identified three themes relating to (1) improving GP knowledge and confidence in identifying individuals with an ARMS, (2) balancing the over- and under-identification of individuals with an ARMS in primary care, and (3) supporting GPs as significant stakeholders in early diagnosis and treatment of individuals with an ARMS. Conclusions Improved identification of individuals with an ARMS is needed. We identified various strategies, including development and implementation of identification methods (e.g., screening measures), educational interventions for GPs (e.g., workshops), and systemic interventions (e.g., simplifying referrals to secondary care, developing integrated services). When implemented successfully, these interventions may help facilitate the access to appropriate care for individuals with an ARMS.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1111/eip.13365

Authors


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Role:
Author
ORCID:
0000-0001-5945-8858
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Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
ORCID:
0000-0002-2749-1386
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Role:
Author
ORCID:
0000-0003-3188-1966
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
ORCID:
0000-0003-3355-3202


Publisher:
Wiley
Journal:
Early Intervention in Psychiatry More from this journal
Volume:
17
Issue:
5
Pages:
429-446
Publication date:
2023-01-11
Acceptance date:
2023-01-02
DOI:
EISSN:
1751-7893
ISSN:
1751-7885
Pmid:
36632681


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1322097
Local pid:
pubs:1322097
Deposit date:
2023-01-17

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