{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T16:28:02Z","timestamp":1787329682294,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>First\u2010episode psychosis (FEP) is a critical phase in the illness trajectory, where early detection and reduced duration of untreated psychosis (DUP) are strongly associated with improved clinical outcomes. However, substantial heterogeneity exists in how individuals present for initial psychiatric care, and data from the Gulf region remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify clinically relevant subgroups of FEP patients in Oman using a data\u2010driven clustering approach and to explore factors associated with treatment delays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective exploratory study reviewed electronic medical records of antipsychotic\u2010na\u00efve FEP patients presenting to Sultan Qaboos University Hospital, Muscat, from January 2010 to December 2020. Age, gender, neurological examination results, and DUP (standardized to days) were extracted. K\u2010means clustering was applied to identify latent patient subgroups, with the optimal solution selected using silhouette coefficients. Descriptive comparisons were then conducted to characterize cluster differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 121 patients met inclusion criteria. Two clusters were identified (average silhouette \u2248\u20090.46). Cluster 1 comprised younger patients with short DUP (median 20\u2009years; DUP\u224830\u2009days), whereas Cluster 2 represented older patients with markedly prolonged DUP (median 39\u2009years; DUP\u224860\u2009days), with 39% experiencing delays &gt;\u20096\u2009months and 27% &gt;\u20091\u2009year. Cluster 2 showed a higher frequency of schizophrenia\u2010spectrum diagnoses. Age and DUP differed significantly between clusters (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), whereas gender distribution, neurological abnormalities, and neuroimaging findings were comparable (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05 for all).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FEP patients in Oman appear to separate into a younger, early\u2010presenting subgroup and an older subgroup experiencing substantial treatment delays. These findings indicate that delayed access to care is driven more by sociodemographic and illness\u2010course factors than neurological pathology. Enhancing early recognition pathways, particularly for later\u2010onset or insidious presentations, may help reduce DUP and improve long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eip.70200","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:27:11Z","timestamp":1782311231000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early\u2010 vs. Late\u2010Presenting First\u2010Episode Psychosis in Oman: A Cluster Analysis of Clinical Subgroups"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8318-7422","authenticated-orcid":false,"given":"Mohsin","family":"Al Farsi","sequence":"first","affiliation":[{"name":"Department of Behavioral Medicine, College of Medicine and Health Sciences Sultan Qaboos University  Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7429-1504","authenticated-orcid":false,"given":"Tamadhir","family":"Al\u2010Mahrouqi","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine, College of Medicine and Health Sciences Sultan Qaboos University  Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-5377","authenticated-orcid":false,"given":"Mohammed","family":"Al Alawi","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine, College of Medicine and Health Sciences Sultan Qaboos University  Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Al Balushi","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine Sultan Qaboos University Hospital  Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjpmh.2023.04.001"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1192\/S0007125000297663"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbae201"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.0623"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.43.s50"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2025.1642460"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171200089X"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbaa089"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20822"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010042949"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127\u2010008\u20100384\u20103"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/00912174241247611"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2023.04.001"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2025.08.016"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/916198"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/eip.13466"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbab145"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291723003458"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380\u2010021\u201001161\u20107"}],"container-title":["Early 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