Associations between rural/urban status, duration of untreated psychosis and mode of onset of psychosis: a mental health electronic clinical records analysis in the East of England, UK.

Karolina Kaminska, Jo Hodgekins, Jonathan R Lewis, Rudolf N Cardinal, Sherifat Oduola

Abstract read

In one paragraph

Article in Social psychiatry and psychiatric epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it

0cells of the map it votes in

1citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Changing the trajectories of mental health difficulties in Norfolk and Suffolk: a research-priority-setting project with patients, the public, clinicians, policymakers and other stakeholders-study protocol.BMJ open · 2025
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Karolina KaminskaNorwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.

Jo HodgekinsNorwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.

Jonathan R LewisCambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Elizabeth House, Fulbourn, Cambridge, CB21 5EF, UK.

Rudolf N CardinalDepartment of Psychiatry, University of Cambridge, Clifford Allbutt Building, Bay 13, Cambridge Biomedical Campus, Cambridge, CB2 0AH, UK.

Sherifat OduolaCambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Elizabeth House, Fulbourn, Cambridge, CB21 5EF, UK. s.oduola@uea.ac.uk.

Funding

Health Services and Delivery Research Programme HS&DR 131871Medical Research Council MR/W014386/1NIHR Cambridge Biomedical Research Centre NIHR203312Programme Development Grants PDG 203683

6 · The paper itself

Abstract

purposeThe influence of rurality on the duration of untreated psychosis (DUP) in first-episode psychosis (FEP) is poorly understood. We investigated factors associated with FEP in rural/urban settings and whether there are rural/urban differences in DUP and the mode (speed) of onset of psychosis.

methodsWe used the Cambridgeshire and Peterborough NHS Foundation Trust Research Database (CPFTRD) to identify all persons presenting to an early intervention for psychosis service with FEP between 2013 and 2015. We performed descriptive statistics and multivariable linear and multinomial regression to assess the relationships between the study outcomes and the independent variables.

resultsOne hundred and fifty-five FEP patients were identified, with a mean age of 23.4 (SD, 5.3) years. The median DUP was 129.0 (IQR: 27.5-524.0) days. In rural areas, FEP patients were more likely to be employed and live with family than those in urban areas. A longer DUP was observed among patients with an insidious onset of psychosis compared with an acute onset (619.5 (IQR: 333.5-945.0)) vs. (17.0 (IQR: 8.0-30.5)) days respectively, p < 0.0001. We found evidence that the mode of onset of psychosis differed by employment status and living circumstances. There was insufficient evidence of rural/urban differences in DUP and mode of onset of psychosis.

conclusionsOur results suggest that the mode of onset of psychosis is an important indicator of treatment delay and could provide vital information for service planning and delivery. Sociodemographic variations in FEP exist in rural populations, and our findings are similar to those observed in urban settings.

Indexed as

Electronic Health RecordsPsychotic DisordersRural PopulationTime-to-TreatmentUrban PopulationAdolescentAdultAge of OnsetEnglandFemaleHumansMaleMental Health ServicesTime FactorsYoung AdultDuration of untreated psychosisFirst-episode psychosisRuralSociodemographic characteristicsUrban

Identifiers

PMID39251413

DOI10.1007/s00127-024-02758-3

PMCPMC12162678

What OpenQuestion holds

Textmetadata

LicenceCC BY

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.