ArticleSchizophrenia (Heidelberg, Germany)2022
Multidimensional analysis of adult patients' care trajectories before a first diagnosis of schizophrenia.
Article in Schizophrenia (Heidelberg, Germany), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Prevalence of schizophrenia spectrum and other psychotic disorders in problem gambling: A systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2024Pooled it
- Care Trajectories of People With Mood Disorders in Quebec Using a Sequence Analysis Method.Brain and behavior · 2026Article
- Article
- Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status?Autism research : official journal of the International Society for Autism Research · 2025Article
- Sequence Analysis to Phenotype Health Care Patterns in Adults With Musculoskeletal Conditions Using Primary Care Electronic Health Records.Arthritis care & research · 2025Article
- Pathways to autism diagnosis in adulthood.Journal of neurodevelopmental disorders · 2025Article
- State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID-19 onset.Addiction (Abingdon, England) · 2025Article
- Care trajectories of people with mood disorders in Quebec using latent class and latent profile analysis methods.Journal of mood and anxiety disorders · 2025Article
- Longitudinal trajectories of substance use disorder treatment use: A latent class growth analysis using a national cohort in Chile.Addiction (Abingdon, England) · 2024Article
- Treatment with psychostimulants and atomoxetine in people with psychotic disorders: reassessing the risk of clinical deterioration in a real-world setting.The British journal of psychiatry : the journal of mental science · 2024Article
- Discovering patterns in outpatient neurology appointments using state sequence analysis.BMC health services research · 2023Article
- Racial differences in pathways to care preceding first episode mania or psychosis: a historical cohort prodromal study.Frontiers in psychiatry · 2023Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
For patients at high-risk for developing schizophrenia, a delayed diagnosis could be affected, among many reasons, by their patterns of healthcare use. This study aims to describe and generate a typology of patients' care trajectories (CTs) in the 2 years preceding a first diagnosis of schizophrenia, over a medico-administrative database of 3712 adults with a first diagnosis between April 2014 and March 2015 in Quebec, Canada. This study applied a multidimensional approach of State Sequence Analysis, considering together sequences of patients' diagnoses, care settings and care providers. Five types of distinct CTs have emerged from this data-driven analysis: The type 1, shared by 77.6% of patients, predominantly younger men, shows that this group sought little healthcare, among which 17.5% had no healthcare contact for mental disorders. These individuals might benefit from improved promotion and prevention of mental healthcare at the community level. The types 2, 3 and 4, with higher occurrence of mental disorder diagnoses, represent together 19.5% of the study cohort, mostly middle-aged and women. These CTs, although displaying roughly similar profiles of mental disorders, revealed very dissimilar sequences and levels of care providers encounters, primary and specialized care use, and hospitalizations. Surprisingly, patients of these CTs had few consultations with general practitioners. An increased attentiveness for middle-aged patients and women with high healthcare use for mental disorders could help to reduce delayed diagnosis of schizophrenia. This calls for further consideration of healthcare services for severe mental illness beyond those offered to young adults.
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Registered trials
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