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Reducing the duration of untreated first-episode psychosis: effects on clinical presentation.
Arch Gen Psychiatry. 2004 Feb; 61(2):143-50.AG

Abstract

CONTEXT

Most studies on first-episode psychosis show an association between a long duration of untreated psychosis (DUP) and poorer short-term outcome, but the mechanisms of this relationship are poorly understood.

OBJECTIVE

To determine whether it is possible to reduce the DUP for first-episode patients in a defined health care area through the introduction of an early detection (ED) program, compared with parallel health care areas without an ED program (No-ED).

SETTING AND PATIENTS

We included consecutive patients with a DSM-IV diagnosis of nonorganic, nonaffective psychosis coming to their first treatment in the study health care areas between January 1, 1997, and December 31, 2000. A total of 281 patients (76% of the total) gave informed consent.

INTERVENTIONS

The ED and No-ED health care areas offered an equivalent assessment and treatment program for first-episode psychosis. The ED area also carried out an intensive ED program.

RESULTS

The DUP was significantly shorter for the group of patients coming from the ED area, compared with patients from the No-ED areas (median, 5 weeks [range, 0-1196 weeks] vs 16 weeks [range, 0-966 weeks]). Clinical status measured by the Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale was significantly better for patients from the ED area at start of treatment and, with the exception of Positive and Negative Syndrome Scale positive subscale, at 3 months. Multiple linear regression analyses gave no indication that confounders were responsible for these differences.

CONCLUSIONS

It is possible to reduce the DUP through an ED program. The reduction in DUP is associated with better clinical status at baseline that is maintained after 3 months.

Authors+Show Affiliations

Division of Psychiatry, Ullevaal University Hospital, Oslo, Norway. Ingrid.melle@psykiatri.uio.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14757590

Citation

Melle, Ingrid, et al. "Reducing the Duration of Untreated First-episode Psychosis: Effects On Clinical Presentation." Archives of General Psychiatry, vol. 61, no. 2, 2004, pp. 143-50.
Melle I, Larsen TK, Haahr U, et al. Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Arch Gen Psychiatry. 2004;61(2):143-50.
Melle, I., Larsen, T. K., Haahr, U., Friis, S., Johannessen, J. O., Opjordsmoen, S., Simonsen, E., Rund, B. R., Vaglum, P., & McGlashan, T. (2004). Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Archives of General Psychiatry, 61(2), 143-50.
Melle I, et al. Reducing the Duration of Untreated First-episode Psychosis: Effects On Clinical Presentation. Arch Gen Psychiatry. 2004;61(2):143-50. PubMed PMID: 14757590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. AU - Melle,Ingrid, AU - Larsen,Tor K, AU - Haahr,Ulrik, AU - Friis,Svein, AU - Johannessen,Jan Olav, AU - Opjordsmoen,Stein, AU - Simonsen,Erik, AU - Rund,Bjørn Rishovd, AU - Vaglum,Per, AU - McGlashan,Thomas, PY - 2004/2/6/pubmed PY - 2004/2/26/medline PY - 2004/2/6/entrez SP - 143 EP - 50 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 61 IS - 2 N2 - CONTEXT: Most studies on first-episode psychosis show an association between a long duration of untreated psychosis (DUP) and poorer short-term outcome, but the mechanisms of this relationship are poorly understood. OBJECTIVE: To determine whether it is possible to reduce the DUP for first-episode patients in a defined health care area through the introduction of an early detection (ED) program, compared with parallel health care areas without an ED program (No-ED). SETTING AND PATIENTS: We included consecutive patients with a DSM-IV diagnosis of nonorganic, nonaffective psychosis coming to their first treatment in the study health care areas between January 1, 1997, and December 31, 2000. A total of 281 patients (76% of the total) gave informed consent. INTERVENTIONS: The ED and No-ED health care areas offered an equivalent assessment and treatment program for first-episode psychosis. The ED area also carried out an intensive ED program. RESULTS: The DUP was significantly shorter for the group of patients coming from the ED area, compared with patients from the No-ED areas (median, 5 weeks [range, 0-1196 weeks] vs 16 weeks [range, 0-966 weeks]). Clinical status measured by the Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale was significantly better for patients from the ED area at start of treatment and, with the exception of Positive and Negative Syndrome Scale positive subscale, at 3 months. Multiple linear regression analyses gave no indication that confounders were responsible for these differences. CONCLUSIONS: It is possible to reduce the DUP through an ED program. The reduction in DUP is associated with better clinical status at baseline that is maintained after 3 months. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/14757590/Reducing_the_duration_of_untreated_first_episode_psychosis:_effects_on_clinical_presentation_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archpsyc.61.2.143 DB - PRIME DP - Unbound Medicine ER -