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Malinowski F, Noto C, Cavalcante D, Belangero S, Ziebold C, Bressan R, Gadelha A. Urban distance to mental healthcare units and public transport increases duration of untreated psychosis in first-episode patients. Int J Soc Psychiatry 2023; 69:1938-1948. [PMID: 37332226 DOI: 10.1177/00207640231180825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND There is a growing interest in environmental and social determinants of mental health. However, how distance to healthcare and public transportation affect illness is neglected in schizophrenia research. Here, we are interested in how the availability of mental healthcare and the ways to reach it may be associated with psychosis. AIMS We aim to investigate the association between distances to healthcare units and subway stations and duration of untreated psychosis (DUP) and greater initial severity in an antipsychotic-naïve first episode of psychosis (FEP) sample. METHOD Using 212 untreated FEP patients' data, we calculated the distances from their residences to the places of interest. Diagnoses comprehended schizophrenia spectrum disorders, depressive and bipolar affective disorders, and substance-induced disorders. Linear regressions were performed with distances as independent variables, DUP and Positive and Negative Syndrome Scale (PANSS) scores as dependent variables. RESULTS Longer distance to emergency mental healthcare was related to longer DUP (95% CI: p = .034, B = 0.152) and higher total PANSS (95% CI: p = .007, B = 0.0189); longer distance to community mental healthcare units was related to longer DUP (95% CI: p = .004, B = 0.0204) and higher total PANSS (95% CI: p = .030, B = 0.152). Moreover, a longer distance to the closest subway station predicted longer DUP (95% CI: p = .019, B = 0.170). CONCLUSION Our results indicate that poor healthcare access is related to longer DUP and higher initial PANSS scores. Future research should investigate how investments in mental health access and actions to improve public transport access could impact DUP and treatment outcomes in psychosis patients.
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Affiliation(s)
- Fernando Malinowski
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Cristiano Noto
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
- Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Daniel Cavalcante
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Síntia Belangero
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Morphology and Genetics, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Carolina Ziebold
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rodrigo Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), EPM-UNIFESP, São Paulo, SP, Brazil
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Fonseca L, Diniz E, Mendonça G, Malinowski F, Mari J, Gadelha A. Schizophrenia and COVID-19: risks and recommendations. ACTA ACUST UNITED AC 2020; 42:236-238. [PMID: 32294689 PMCID: PMC7236151 DOI: 10.1590/1516-4446-2020-0010] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Lais Fonseca
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Elton Diniz
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | | | - Fernando Malinowski
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| | - Jair Mari
- Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil.,Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), UNIFESP, São Paulo, SP, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil.,Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), UNIFESP, São Paulo, SP, Brazil
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Riße K, Rummel T, Freundt S, Dudek A, Renard S, Bykov V, Köppen M, Langish S, Neilson G, Brown T, Chrzanowski J, Mardenfeld M, Malinowski F, Khodak A, Zhao X, Eksaa G. Design and manufacturing status of trim coils for the Wendelstein 7-X stellarator experiment. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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