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21 January 2021
GPs are in a good position to identify patients who are at risk of developing psychosis. However, it is not always easy for them to do so. In a recent study of the possible barriers, researchers at the University of Bristol’s Centre for Academic Primary Care and Centre for Academic Mental Health found that not all GPs were familiar with the concept of being ‘at risk of developing psychosis’ and some felt they would benefit from further training in identifying patients who might fall into this group.
The research, funded by the NIHR Biomedical Research Centre at the University of Bristol and published in the British Journal of General Practice, explored GPs’ views and experiences of identifying patients with an ‘at-risk’ mental state. Twenty GPs from the South West of England were interviewed between March and July 2019.
Other barriers to managing patients with an at-risk mental state included patients not presenting or disclosing psychotic symptoms, lack of continuity of care (i.e. being seen by the same GP), and only the most severely ill patients being able to access specialist mental health services.
Daniela Strelchuk, lead author of the study, said: “About a third of people who experience early symptoms of psychosis, such as hearing voices or holding paranoid beliefs, will go on to develop psychotic illness over a three-year period. GPs play a key role in referring these patients to secondary care services but the results of our study show that not all GPs were familiar with this patient group. GP training on the early symptoms of psychosis and the use of short screening tools might help improve identification. This is important because early intervention can reduce rates of transition to psychosis by approximately 50 per cent.”
Professor Katrina Turner, from the Centre for Academic Primary Care who supervised the study, said : “Identifying people at risk of psychosis in primary care is difficult, and GPs may lack the time and confidence to do this. Provision of GP training might help, along with greater support for continuity of care and improved access to specialist services.”
Paper: Identifying patients at risk of psychosis: a qualitative study of GP views in South West England by Daniela Strelchuk et al. Published in British Journal of General Practice (BJGP). November 2020.
Listen to the BJGP podcast about the study with authors Daniela Strelchuk and Professor Stanley Zammit.
Further information
About the Centre for Academic Primary Care
The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.
About the Centre for Academic Mental Health
The Centre for Academic Mental Health at the University of Bristol conducts research within a number of themes related to mental health. We provide research training opportunities in these areas, and in partnership with our NHS colleagues, we provide undergraduate teaching in psychiatry. The Centre sits within Bristol Medical School at the University of Bristol.
About NIHR Bristol Biomedical Research Centre
NIHR Bristol Biomedical Research Centre’s (BRC) innovative biomedical research takes science from the laboratory bench or computer and develops it into new drugs, treatments or health advice. Its world-leading scientists work on many aspects of health, from the role played by individual genes and proteins to analysing large collections of data on hundreds of thousands of people. Bristol BRC is unique among the NIHR’s 20 BRCs across England, thanks to its expertise in ground-breaking population health research.
About the National Institute for Health Research
The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:
- funds, supports and delivers high quality research that benefits the NHS, public health and social care
- engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
- attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
- invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
- partners with other public funders, charities and industry to maximise the value of research to patients and the economy.
The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.
