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The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis.
Psychol Med. 2008 Aug; 38(8):1157-66.PM

Abstract

BACKGROUND

The association between the duration of untreated psychosis (DUP) and outcome of schizophrenia may be confounded by other factors such as poor pre-morbid adjustment. The aim of the present study was to examine the independent contributions of DUP and of pre-morbid adjustment to the clinical and social outcomes of schizophrenia.

METHOD

A longitudinal, prospective, 2-year follow-up study of 423 patients with first-episode schizophrenia-spectrum psychosis was conducted. Patients were comprehensively assessed at entry, 1-year and 2-year follow-up. At entry, DUP was measured by IRAOS (an instrument for the assessment of onset and early course of schizophrenia) and pre-morbid adjustment was measured by the Pre-morbid Adjustment Scale (PAS) as 'pre-morbid social adaptation' and 'pre-morbid school adaptation'. Outcome measures included the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Social Network Schedule and social information. Multiple linear regression models were used for data analysis.

RESULTS

The median DUP was 48 weeks, which is long compared to other studies. Longer DUP was independently associated with more psychotic symptoms at entry, 1-year and 2-year follow-up. Poorer pre-morbid social adaptation was independently associated with more negative symptoms and smaller social network at entry and 1-year follow-up. Poorer pre-morbid school adaptation was independently associated with poor vocational outcome at 1-year and 2-year follow-up.

CONCLUSIONS

Longer DUP is associated with poorer 2-year outcome of psychosis in schizophrenia-spectrum disorders, when pre-morbid functioning and other prognostic factors are controlled for. Impaired pre-morbid development is independently associated with more negative symptoms and poorer social outcome.

Authors+Show Affiliations

Psychiatric Centre Bispebjerg, Copenhagen NV, Denmark. pia.jep@dadlnet.dkNo 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)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18447961

Citation

Jeppesen, P, et al. "The Association Between Pre-morbid Adjustment, Duration of Untreated Psychosis and Outcome in First-episode Psychosis." Psychological Medicine, vol. 38, no. 8, 2008, pp. 1157-66.
Jeppesen P, Petersen L, Thorup A, et al. The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis. Psychol Med. 2008;38(8):1157-66.
Jeppesen, P., Petersen, L., Thorup, A., Abel, M. B., Øhlenschlaeger, J., Christensen, T. Ø., Krarup, G., Jørgensen, P., & Nordentoft, M. (2008). The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis. Psychological Medicine, 38(8), 1157-66. https://doi.org/10.1017/S0033291708003449
Jeppesen P, et al. The Association Between Pre-morbid Adjustment, Duration of Untreated Psychosis and Outcome in First-episode Psychosis. Psychol Med. 2008;38(8):1157-66. PubMed PMID: 18447961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis. AU - Jeppesen,P, AU - Petersen,L, AU - Thorup,A, AU - Abel,M-B, AU - Øhlenschlaeger,J, AU - Christensen,T Ø, AU - Krarup,G, AU - Jørgensen,P, AU - Nordentoft,M, Y1 - 2008/04/30/ PY - 2008/5/2/pubmed PY - 2008/11/19/medline PY - 2008/5/2/entrez SP - 1157 EP - 66 JF - Psychological medicine JO - Psychol Med VL - 38 IS - 8 N2 - BACKGROUND: The association between the duration of untreated psychosis (DUP) and outcome of schizophrenia may be confounded by other factors such as poor pre-morbid adjustment. The aim of the present study was to examine the independent contributions of DUP and of pre-morbid adjustment to the clinical and social outcomes of schizophrenia. METHOD: A longitudinal, prospective, 2-year follow-up study of 423 patients with first-episode schizophrenia-spectrum psychosis was conducted. Patients were comprehensively assessed at entry, 1-year and 2-year follow-up. At entry, DUP was measured by IRAOS (an instrument for the assessment of onset and early course of schizophrenia) and pre-morbid adjustment was measured by the Pre-morbid Adjustment Scale (PAS) as 'pre-morbid social adaptation' and 'pre-morbid school adaptation'. Outcome measures included the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Social Network Schedule and social information. Multiple linear regression models were used for data analysis. RESULTS: The median DUP was 48 weeks, which is long compared to other studies. Longer DUP was independently associated with more psychotic symptoms at entry, 1-year and 2-year follow-up. Poorer pre-morbid social adaptation was independently associated with more negative symptoms and smaller social network at entry and 1-year follow-up. Poorer pre-morbid school adaptation was independently associated with poor vocational outcome at 1-year and 2-year follow-up. CONCLUSIONS: Longer DUP is associated with poorer 2-year outcome of psychosis in schizophrenia-spectrum disorders, when pre-morbid functioning and other prognostic factors are controlled for. Impaired pre-morbid development is independently associated with more negative symptoms and poorer social outcome. SN - 0033-2917 UR - https://www.unboundmedicine.com/medline/citation/18447961/The_association_between_pre_morbid_adjustment_duration_of_untreated_psychosis_and_outcome_in_first_episode_psychosis_ L2 - https://www.cambridge.org/core/product/identifier/S0033291708003449/type/journal_article DB - PRIME DP - Unbound Medicine ER -