Increased use of primary care during 6 years of prodromal schizophrenia.

Background Early diagnosis is important for the course of schizophrenia. Aim To investigate whether prodromal symptoms of schizophrenia lead to increased use of primary care. Method A register-based cohort study of 21 894 cases with incident schizophrenia and 437 880 matched controls. Results Cases used daytime primary care 43% more than controls during the 6 years before diagnosis ( IRR = 1.43; 95% CI: 1.39; 1.48) and 132% more during the last 2 months ( IRR = 2.32; 95% CI: 2.27; 2.37), and 34% ( IRR = 1.34; 95% CI: 1.23; 1.48) vs. 374% more for out-of-hours services ( IRR = 3.74; 95% CI: 3.52; 3.98). Six years before index diagnosis, 30% of cases had at least one psychiatric contact without being diagnosed with schizophrenia, increasing to 75% 1 month before diagnosis. Conclusion Increased help-seeking behaviour was seen at least 6 years before index diagnosis, suggesting a 'window' for earlier diagnosis of prodromal schizophrenia. [ABSTRACT FROM AUTHOR]