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Article Dans Une Revue Acta Psychiatrica Scandinavica Année : 2022

A systematic review and meta‐analysis of delayed help‐seeking, delayed diagnosis and duration of untreated illness in bipolar disorders

Résumé

Objectives: To examine the time delay between the age at onset of symptoms or episodes of bipolar disorders (BD) and the age at diagnosis of and/or receipt of clinical practice guideline recommended interventions for BD. Methods: Systematic search of five databases to identify publications from January 2000 to July 2022 that reported one or more of the following reliable and valid estimates of latency: delay in help seeking (DHS), delay in diagnosis (DD) and duration of untreated BD (DUB). Eligible studies were included in random effects meta-analyses and multivariate meta-regression was used to assess factors associated with each latency construct. Results: Screening of 1074 publications identified 59 eligible studies (reported in 66 publications) of >40,000 individuals that estimated DHS (8 studies), DD (20 studies) and/or DUB (45 studies). The median DHS, DD and DUB were 3.5 (IQR: 2.8, 8.48), 6.7 (IQR: 5.6, 8.9) and 5.9 years (IQR: 1.1, 8.2), respectively. Key factors associated with shorter DD included older age and residing outside North America; shorter DUB was associated with psychotic or manic onset and access to early intervention services. Conclusions: Greater consensus on definitions of latency constructs and better-quality targeted research is required regarding DHS, DD and DUB. This review suggests that, while the peak age at onset of BD is 15-25, diagnosis and guideline recommended interventions (e.g., mood stabilizers) are likely to be delayed until age 25-35 years except for a minority of individuals with access to early intervention services.
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Dates et versions

hal-03786735 , version 1 (23-09-2022)

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Jan Scott, Anna Graham, Alison Yung, Catherine Morgan, Frank Bellivier, et al.. A systematic review and meta‐analysis of delayed help‐seeking, delayed diagnosis and duration of untreated illness in bipolar disorders. Acta Psychiatrica Scandinavica, 2022, 146 (5), pp.389-405. ⟨10.1111/acps.13490⟩. ⟨hal-03786735⟩
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