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Eligible studies were included in random effects meta\u2010analyses and multivariate meta\u2010regression was used to assess factors associated with each latency construct.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Screening of 1074 publications identified 59 eligible studies (reported in 66 publications) of &gt;40,000 individuals that estimated DHS (8 studies), DD (20 studies) and\/or DUB (45 studies). The median DHS, DD and DUB were 3.5 (IQR: 2.8, 8.48), 6.7 (IQR: 5.6, 8.9) and 5.9\u2009years (IQR: 1.1, 8.2), respectively. Key factors associated with shorter DD included older age and residing outside North America; shorter DUB was associated with psychotic or manic onset and access to early intervention services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Greater consensus on definitions of latency constructs and better\u2010quality targeted research is required regarding DHS, DD and DUB. This review suggests that, while the peak age at onset of BD is 15\u201325, diagnosis and guideline recommended interventions (e.g., mood stabilizers) are likely to be delayed until age 25\u201335\u2009years except for a minority of individuals with access to early intervention services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13490","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T10:10:10Z","timestamp":1661508610000},"page":"389-405","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["A systematic review and meta\u2010analysis of delayed help\u2010seeking, delayed diagnosis and duration of untreated illness in bipolar disorders"],"prefix":"10.1111","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-8601","authenticated-orcid":false,"given":"Jan","family":"Scott","sequence":"first","affiliation":[{"name":"Institute of Neuroscience Newcastle University  Newcastle upon Tyne UK"},{"name":"Brain and Mind Centre The University of Sydney  Sydney Australia"},{"name":"Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Graham","sequence":"additional","affiliation":[{"name":"Projects and Peer Support Officer, Bipolar UK  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Yung","sequence":"additional","affiliation":[{"name":"Institute for Mental and Physical Health and Clinical Translation Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Morgan","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Service Research &amp; Primary Care The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3660-6640","authenticated-orcid":false,"given":"Frank","family":"Bellivier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris  Paris France"},{"name":"D\u00e9partement de Psychiatrie et de M\u00e9decine Addictologique AP\u2010HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint\u2010Louis\u2010Lariboisi\u00e8re\u2010Fernand Widal  Paris France"},{"name":"INSERM, UMR\u2010S 1144, Optimisation Th\u00e9rapeutique en Neuropsychopharmacologie, Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5377-1488","authenticated-orcid":false,"given":"Bruno","family":"Etain","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris  Paris France"},{"name":"D\u00e9partement de Psychiatrie et de M\u00e9decine Addictologique AP\u2010HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint\u2010Louis\u2010Lariboisi\u00e8re\u2010Fernand Widal  Paris France"},{"name":"INSERM, UMR\u2010S 1144, Optimisation Th\u00e9rapeutique en Neuropsychopharmacologie, Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291701003488"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751\u20107893.2008.00080.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.9.975"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004060050091"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v64n0209"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.156.5.811a"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0165\u20100327(98)00076\u20107"},{"issue":"5","key":"e_1_2_12_10_1","first-page":"380","article-title":"(2008) demographical profile and clinical features of patients with bipolar disorder in an outpatient setting in Singapore","volume":"49","author":"Peh A","year":"2008","journal-title":"Singapore Med J"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(94)90104-X"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20105618.2004.00160.x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751\u20107893.2007.00036.x"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12499"},{"key":"e_1_2_12_15_1","unstructured":"ScottJ.Revue systematique de la duree de la maladie non traitee (DMNT) dans les troubles bipolaires: problemes de definition et solutions potentielles. 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