Pregnancy Anxiety as a Social Symptom: Personal Accounts of Pregnant Women During the COVID-19 Pandemic in Quebec.

The first episode of psychosis (FEP) is a critical therapeutic time point. Good recovery outcomes can be achieved if patients are treated promptly and effectively (Farooq et al. , ). However, individuals suffering from FEP often experience a significant delay between the onset of psychotic symptoms and the initiation of treatment. This is especially critical in low‐ and middle‐income countries (LMICs), where it is estimated that over 80% of all FEP takes place (Singh and Javed ). Significantly, two‐thirds of the population of Pakistan is below the age of 30, making it among the world's youngest nations (Ahmad ). Yet, early intervention in psychosis (EIP) services in Pakistan, like other LMICs, are underdeveloped and lacking. There is a severe shortage of mental health professionals, with recent estimates of around 500 registered psychiatrists for the entire population of over 245 million people (Sikander ). The duration of untreated psychosis (DUP), defined as the time from manifestation of the first psychotic symptom to initiation of adequate treatment from a qualified mental health professional (Marshall et al. ), is likely to vary considerably in patients depending on their help‐seeking pattern. Measuring the DUP is a critical component in early intervention research. Because the onset of psychosis is typically a gradual process rather than an abrupt event, researchers utilise a variety of specialised assessment tools to retrospectively map this transition. The Nottingham Onset Schedule (NOS), developed by Singh et al. (), stands out as a highly reliable and validated instrument for measuring DUP. Notably, DUP is alarmingly protracted in most LMICs, where the average DUP is 125 weeks, which is twice as long as the 63 weeks of DUP in high‐income countries (HICs) (Large et al. ). Lilford et al. found that DUP in LMICs ranges from a mean of 30–225 weeks (Lilford et al. ). Research demonstrates that a longer DUP is associated with a longer time to symptom remission, a lesser degree of recovery, a greater likelihood of relapse and a worse overall outcome (Farooq et al. ; Singh et al. ). Significant resources have been devoted to EIP on the grounds that reducing DUP improves health outcomes (Csillag et al. ).