Motivation of Primary Care Physicians for Participating in Early Intervention for Psychosis in Japan

Motivation of Primary Care Physicians for Participating in Early Intervention for Psychosis in Japan

MITSUYUKI TAKAMURA,^1,2 NORIKO HAGI^1,3 and KAZUHITO YOKOYAMA¹

¹Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Tokyo, Japan
²Mie University Hospital, Tsu, Japan
³Department of Psychiatric Nursing, Yokkaichi Nursing and Medical Care University, Yokkaichi, Japan

People with psychosis as represented by schizophrenia experience lengthy delays between the onset and the start of treatment. This duration is called Duration of Untreated Psychosis (DUP). Since it has been indicated that shorter DUP leads to their better prognosis, early intervention has been a hot topic for decades in clinical psychiatry. In Japan, as any patient can visit either specialists or primary care physicians using medical insurance, a considerable portion of psychosis patients are supposed to visit the latter first. Thus, a role of primary care physicians seems keys of success in implementation of early intervention system in the Japanese society. In this study, to clarify the motivation of physicians to participate in early intervention, we sent postal questionnaires to 4030 private clinics throughout Japan, inquiring physicians' situations around psychiatric disorders. Seven hundred and fourteen questionnaires were used for analysis (17.7%). Among these 714 respondents, 364 (51.0%) reported that they have willingness to participate in early intervention. Similarly, 494 (69.2%) were interested in psychiatric disorders, whereas only 168 (23.5%) were confident in identifying schizophrenia. The interest in psychiatric disorders was most strongly associated with their willingness to participate (Odds ratio = 3.54 by logistic regression analysis). These results, therefore, suggest that the interest in psychiatric disorders motivates them to participate in early intervention for psychosis; this has considerable implications for future approach to build up early intervention system in Japan.

keywords —— duration of untreated psychosis; early intervention for psychosis; gatekeeper; primary care; schizophrenia

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Tohoku J. Exp. Med., 2011, 225, 43-49

Correspondence: Kazuhito Yokoyama, M.D., Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

e-mail: kyokoya@juntendo.ac.jp