Trayectoria diagnóstica posterior al primer episodio psicótico en pacientes de un centro de tercer nivel del Oriente antioqueño

Objective

To describe the diagnostic trajectory from the first psychotic episode (FPE) to the diagnosis of a psychiatric disorder in adults from Eastern Antioquia and explore associated characteristics.

Method

A medical records-based retrospective follow-up study. Adult patients from Eastern Antioquia diagnosed with FPE according to the psychiatrist's criteria and treated at a tertiary care medical center (2007 to March 2022) were included. Time to psychiatric diagnosis after the FPE was the outcome variable. In addition, factors associated with bipolar affective disorder and schizophrenia were analyzed using the survival model for competitive events.

Results

One hundred and thirty-seven patients were included, 40.9% women, median age 36 years (IQR = 26). 48.2% had personal psychiatric history, and 32.8% had a family history. At one year, 84.9% had received a diagnosis of psychiatric disorder, bipolar affective disorder in 39.8%, and schizophrenia in 24.7% of cases. Bipolar affective disorder was the most likely diagnostic trajectory in patients: women, with family psychiatric history and current use of psychoactive substances. Schizophrenia was in patients: men, with a personal psychiatric history, and with higher days of untreated psychosis.

Conclusion

Integrated healthcare routes for the FPE that recognize the particularities of the epidemiology of mental disorders in Eastern Antioquia are required.