Care Pathways Before First Diagnosis of a Psychotic Disorder in Adolescents and Young Adults

Objective:The authors sought to describe patterns of health care use prior to first diagnosis of a psychotic disorder in a population-based sample.Method:Electronic health records and insurance claims from five large integrated health systems were used to identify 624 patients 15–29 years old who received a first diagnosis of a psychotic disorder in any care setting and to record health services received, diagnoses assigned, and medications dispensed during the previous 36 months. Patterns of utilization were compared between patients receiving a first diagnosis of a psychotic disorder and matched samples of general health system members and members receiving a first diagnosis of unipolar depression.Results:During the year before a first psychotic disorder diagnosis, 29% of patients had mental health specialty outpatient care, 8% had mental health inpatient care, 24% had emergency department mental health care, 29% made a primary care visit with a mental health diagnosis, and 60% received at least one men...