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Impact of duration of untreated psychosis on pre-treatment, baseline, and outcome characteristics in an epidemiological first-episode psychosis cohort.
J Psychiatr Res. 2008 Oct; 42(12):982-90.JP

Abstract

INTRODUCTION

To assess the impact of duration of untreated psychosis (DUP) on baseline and 18-month follow-up characteristics controlling for relevant confounders in an epidemiological first-episode psychosis (FEP) cohort.

METHOD

The Early Psychosis Prevention and Intervention Centre (EPPIC) in Australia admitted 786 FEP patients from January 1998 to December 2000. Data were collected from medical files using a standardized questionnaire. Data from 636 patients were analyzed.

RESULTS

Median DUP was 8.7 weeks. Longer DUP was associated with worse premorbid functioning (p<0.001), higher rate of schizophrenia-spectrum disorders (p<0.001), and younger age at onset of psychosis (p=0.004). Longer DUP was not associated with baseline variables but with a lower rate of remission of positive symptoms (p<0.001) and employment/occupation (p<0.001), a higher rate of persistent substance use (p=0.015), worse illness severity (p<0.001) and global functioning (p<0.001) at follow-up after controlling for relevant confounders, explaining approximately 5% of variance of remission of positive symptoms (p<0.001) in the total sample and 3% in schizophrenia-spectrum disorders excluding bipolar I disorder (p=0.002). Outcome was significantly worse when DUP exceeded 1-3 months.

CONCLUSION

Avoiding pitfalls of non-epidemiological studies, DUP appears to be a modest independent predictor of prognosis in the medium-term. Results support the need for assertive early detection strategies.

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Authors+Show Affiliations

Schimmelmann BG
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Virchowstrasse 174, 45147 Essen, Germany. bschimme@aol.com
Huber CG
No affiliation info available
Lambert M
No affiliation info available
Cotton S
No affiliation info available
McGorry PD
No affiliation info available
Conus P
No affiliation info available

MeSH

AdolescentAdultAge of OnsetAustraliaCohort StudiesDiagnostic and Statistical Manual of Mental DisordersEmploymentFemaleFollow-Up StudiesHumansMaleOccupationsPrognosisPsychiatric Status Rating ScalesPsychotic DisordersQuality of LifeRisk FactorsSchizophreniaSchizophrenic PsychologySeverity of Illness IndexSurveys and QuestionnairesTime FactorsTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18199456

Citation

Schimmelmann, Benno G., et al. "Impact of Duration of Untreated Psychosis On Pre-treatment, Baseline, and Outcome Characteristics in an Epidemiological First-episode Psychosis Cohort." Journal of Psychiatric Research, vol. 42, no. 12, 2008, pp. 982-90.
Schimmelmann BG, Huber CG, Lambert M, et al. Impact of duration of untreated psychosis on pre-treatment, baseline, and outcome characteristics in an epidemiological first-episode psychosis cohort. J Psychiatr Res. 2008;42(12):982-90.
Schimmelmann, B. G., Huber, C. G., Lambert, M., Cotton, S., McGorry, P. D., & Conus, P. (2008). Impact of duration of untreated psychosis on pre-treatment, baseline, and outcome characteristics in an epidemiological first-episode psychosis cohort. Journal of Psychiatric Research, 42(12), 982-90. https://doi.org/10.1016/j.jpsychires.2007.12.001
Schimmelmann BG, et al. Impact of Duration of Untreated Psychosis On Pre-treatment, Baseline, and Outcome Characteristics in an Epidemiological First-episode Psychosis Cohort. J Psychiatr Res. 2008;42(12):982-90. PubMed PMID: 18199456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of duration of untreated psychosis on pre-treatment, baseline, and outcome characteristics in an epidemiological first-episode psychosis cohort. AU - Schimmelmann,Benno G, AU - Huber,Christian G, AU - Lambert,Martin, AU - Cotton,Sue, AU - McGorry,Patrick D, AU - Conus,Philippe, Y1 - 2008/01/15/ PY - 2007/09/06/received PY - 2007/11/25/revised PY - 2007/12/05/accepted PY - 2008/1/18/pubmed PY - 2008/10/31/medline PY - 2008/1/18/entrez SP - 982 EP - 90 JF - Journal of psychiatric research JO - J Psychiatr Res VL - 42 IS - 12 N2 - INTRODUCTION: To assess the impact of duration of untreated psychosis (DUP) on baseline and 18-month follow-up characteristics controlling for relevant confounders in an epidemiological first-episode psychosis (FEP) cohort. METHOD: The Early Psychosis Prevention and Intervention Centre (EPPIC) in Australia admitted 786 FEP patients from January 1998 to December 2000. Data were collected from medical files using a standardized questionnaire. Data from 636 patients were analyzed. RESULTS: Median DUP was 8.7 weeks. Longer DUP was associated with worse premorbid functioning (p<0.001), higher rate of schizophrenia-spectrum disorders (p<0.001), and younger age at onset of psychosis (p=0.004). Longer DUP was not associated with baseline variables but with a lower rate of remission of positive symptoms (p<0.001) and employment/occupation (p<0.001), a higher rate of persistent substance use (p=0.015), worse illness severity (p<0.001) and global functioning (p<0.001) at follow-up after controlling for relevant confounders, explaining approximately 5% of variance of remission of positive symptoms (p<0.001) in the total sample and 3% in schizophrenia-spectrum disorders excluding bipolar I disorder (p=0.002). Outcome was significantly worse when DUP exceeded 1-3 months. CONCLUSION: Avoiding pitfalls of non-epidemiological studies, DUP appears to be a modest independent predictor of prognosis in the medium-term. Results support the need for assertive early detection strategies. SN - 0022-3956 UR - https://www.unboundmedicine.com/medline/citation/18199456/Impact_of_duration_of_untreated_psychosis_on_pre_treatment_baseline_and_outcome_characteristics_in_an_epidemiological_first_episode_psychosis_cohort_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3956(07)00209-9 DB - PRIME DP - Unbound Medicine ER -