PMID- 11278138
OWN - NLM
STAT- MEDLINE
DCOM- 20010628
LR  - 20190915
IS  - 0920-9964 (Print)
IS  - 0920-9964 (Linking)
VI  - 47
IP  - 2-3
DP  - 2001 Mar 1
TI  - Duration of untreated psychosis predicts treatment outcome in an early psychosis 
      program.
PG  - 215-22
AB  - For patients first presenting with a non-affective psychotic disorder, the 
      duration of untreated psychosis (DUP; the time between the onset of positive 
      psychotic symptoms and the initiation of appropriate treatment) varies widely, 
      from a few weeks to several years. A number of studies report that a longer DUP 
      is associated with poorer clinical outcomes. We studied DUP and its association 
      with clinical outcomes in a group of patients with schizophrenia and related 
      psychotic disorders treated in the naturalistic clinical setting of an early 
      psychosis program. DUP was determined for 19 patients with a non-affective 
      psychotic disorder (schizophrenia, schizoaffective disorder or schizophreniform 
      disorder) and no previous treatment for psychosis, by use of the IRAOS, a 
      retrospective structured interview carried out with patients and their families. 
      Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Function 
      (GAF) ratings were available at baseline and 6month follow-up. For analysis, 
      patients were categorized into a short DUP (n=9) or long DUP (n=10) group. The 
      median DUP (57weeks) was used as the dividing point. At baseline, the two groups 
      did not differ significantly on positive symptoms or total PANSS ratings. 
      However, negative symptoms were more severe in the long DUP group at baseline 
      (P=0.029), and the long DUP group had a significantly higher mean rating for the 
      passive/apathetic social withdrawal item of the PANSS (P=0.024). At 6month 
      follow-up, the long DUP group had significantly higher ratings for positive 
      symptoms (P=0.028) and had lower GAF scores (P=0.044). Significantly more 
      (P=0.033) long DUP patients had enduring positive psychotic symptoms. The results 
      confirm both the wide range of DUP among patients first presenting with 
      schizophrenia and related psychotic disorders and the association of long DUP, 
      defined as greater than approximately 1year, with a poorer clinical outcome. This 
      study highlights the importance of collecting data regarding DUP and supports the 
      view that patients with a long DUP are likely to be less responsive to treatment 
      in general and will require greater resources and more intensive interventions.
FAU - Black, K
AU  - Black K
AD  - Mental Health Services, QEII Health Science Centre, Halifax, Nova Scotia, Canada.
FAU - Peters, L
AU  - Peters L
FAU - Rui, Q
AU  - Rui Q
FAU - Milliken, H
AU  - Milliken H
FAU - Whitehorn, D
AU  - Whitehorn D
FAU - Kopala, L C
AU  - Kopala LC
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antipsychotic Agents/*therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Interview, Psychological
MH  - Male
MH  - Prognosis
MH  - *Psychotic Disorders/diagnosis/etiology/therapy
MH  - Remission, Spontaneous
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Schizophrenia/diagnosis
MH  - Schizophrenic Psychology
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2001/03/30 10:00
MHDA- 2001/06/29 10:01
CRDT- 2001/03/30 10:00
PHST- 2001/03/30 10:00 [pubmed]
PHST- 2001/06/29 10:01 [medline]
PHST- 2001/03/30 10:00 [entrez]
AID - S0920996400001444 [pii]
AID - 10.1016/s0920-9964(00)00144-4 [doi]
PST - ppublish
SO  - Schizophr Res. 2001 Mar 1;47(2-3):215-22. doi: 10.1016/s0920-9964(00)00144-4.