Is early management of psychosis designed for migrants? Improving transcultural variable collection when measuring duration of untreated psychosis

Abstract

Aim: A background of migration is an established risk factor for psychosis. At the same time, over the last 25 years, many countries have developed specialized services for the assessment and care of people with early psychosis. Evaluation of these services often focuses on the duration of untreated psychosis (DUP). Methods: We conducted a systematic review with an electronic search of key words in 3 databases to determine the extent to which studies measuring DUP consider transcultural variables, including migration status, national origin, ethnicity and language. Results: We identified 18 studies that included transcultural variables and measured DUP. They differed in their design, aims and methodology, and could not be directly compared. Common themes nonetheless appeared. Conclusions: Most of the studies exploring DUP took little account of transcultural variables. Definitions of transcultural indicators were heterogeneous and often vague. Lack of language proficiency was often an exclusion criterion, and none of the studies used interpreters. We propose some basic transcultural variable and recommendations to include in future studies and recommendations to improve their internal and external validity.