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Prevention of negative symptom psychopathologies in first-episode schizophrenia: two-year effects of reducing the duration of untreated psychosis.
Arch Gen Psychiatry 2008; 65(6):634-40AG

Abstract

BACKGROUND

The duration of untreated psychosis (DUP)-the time from onset of psychotic symptoms to the start of adequate treatment--is consistently correlated with better course and outcome, but the mechanisms are poorly understood.

OBJECTIVE

To report the effects of reducing DUP on 2-year course and outcome.

DESIGN

A total of 281 patients with a DSM-IV diagnosis of nonorganic, nonaffective psychosis coming to their first treatment during 4 consecutive years were recruited, of which 231 participated in the 2-year follow-up. A comprehensive early detection (ED) system, based on public information campaigns and low-threshold-psychosis-detecting teams, was introduced in 1 health care area (ED area), but not in a comparable area (no-ED area). Both areas ran equivalent 2-year treatment programs.

RESULTS

First-episode patients from the ED area had a significantly lower DUP, better clinical status, and milder negative symptoms at the start of treatment. There were no differences in treatment received for the first 2 years between the groups. The difference in negative symptoms was maintained at the 1-year follow-up. There was a statistically significant difference in the Positive and Negative Syndrome Scale negative component, cognitive component, and depressive component in favor of the ED group at the 2-year follow-up. Multiple linear regression analyses gave no indication that these differences were due to confounders.

CONCLUSION

Reducing the DUP has effects on the course of symptoms and functioning, including negative symptoms, suggesting secondary prevention of the negative psychopathologies in first-episode schizophrenia.

Authors+Show Affiliations

Section for Psychosis Research, Division of Psychiatry, Ulleval University Hospital, 0407 Oslo, Norway. ingrid.melle@medisin.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)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18519821

Citation

Melle, Ingrid, et al. "Prevention of Negative Symptom Psychopathologies in First-episode Schizophrenia: Two-year Effects of Reducing the Duration of Untreated Psychosis." Archives of General Psychiatry, vol. 65, no. 6, 2008, pp. 634-40.
Melle I, Larsen TK, Haahr U, et al. Prevention of negative symptom psychopathologies in first-episode schizophrenia: two-year effects of reducing the duration of untreated psychosis. Arch Gen Psychiatry. 2008;65(6):634-40.
Melle, I., Larsen, T. K., Haahr, U., Friis, S., Johannesen, J. O., Opjordsmoen, S., ... McGlashan, T. (2008). Prevention of negative symptom psychopathologies in first-episode schizophrenia: two-year effects of reducing the duration of untreated psychosis. Archives of General Psychiatry, 65(6), pp. 634-40. doi:10.1001/archpsyc.65.6.634.
Melle I, et al. Prevention of Negative Symptom Psychopathologies in First-episode Schizophrenia: Two-year Effects of Reducing the Duration of Untreated Psychosis. Arch Gen Psychiatry. 2008;65(6):634-40. PubMed PMID: 18519821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of negative symptom psychopathologies in first-episode schizophrenia: two-year effects of reducing the duration of untreated psychosis. AU - Melle,Ingrid, AU - Larsen,Tor K, AU - Haahr,Ulrik, AU - Friis,Svein, AU - Johannesen,Jan O, AU - Opjordsmoen,Stein, AU - Rund,Bjørn R, AU - Simonsen,Erik, AU - Vaglum,Per, AU - McGlashan,Thomas, PY - 2008/6/4/pubmed PY - 2008/6/18/medline PY - 2008/6/4/entrez SP - 634 EP - 40 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 65 IS - 6 N2 - BACKGROUND: The duration of untreated psychosis (DUP)-the time from onset of psychotic symptoms to the start of adequate treatment--is consistently correlated with better course and outcome, but the mechanisms are poorly understood. OBJECTIVE: To report the effects of reducing DUP on 2-year course and outcome. DESIGN: A total of 281 patients with a DSM-IV diagnosis of nonorganic, nonaffective psychosis coming to their first treatment during 4 consecutive years were recruited, of which 231 participated in the 2-year follow-up. A comprehensive early detection (ED) system, based on public information campaigns and low-threshold-psychosis-detecting teams, was introduced in 1 health care area (ED area), but not in a comparable area (no-ED area). Both areas ran equivalent 2-year treatment programs. RESULTS: First-episode patients from the ED area had a significantly lower DUP, better clinical status, and milder negative symptoms at the start of treatment. There were no differences in treatment received for the first 2 years between the groups. The difference in negative symptoms was maintained at the 1-year follow-up. There was a statistically significant difference in the Positive and Negative Syndrome Scale negative component, cognitive component, and depressive component in favor of the ED group at the 2-year follow-up. Multiple linear regression analyses gave no indication that these differences were due to confounders. CONCLUSION: Reducing the DUP has effects on the course of symptoms and functioning, including negative symptoms, suggesting secondary prevention of the negative psychopathologies in first-episode schizophrenia. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/18519821/Prevention_of_negative_symptom_psychopathologies_in_first_episode_schizophrenia:_two_year_effects_of_reducing_the_duration_of_untreated_psychosis_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=18519821.ui DB - PRIME DP - Unbound Medicine ER -