Related Experiment Videos
Does treatment delay in first-episode psychosis really matter?
S M Harrigan1, P D McGorry, H Krstev
1University of Melbourne, Department of Psychiatry, Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Victoria, Australia.
Psychological Medicine
|January 23, 2003
Summary
Duration of untreated psychosis (DUP) significantly impacts first-episode psychosis outcomes, independent of other factors. Reducing DUP may improve patient functioning and serve as a key preventive strategy.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Duration of untreated psychosis (DUP) is a malleable predictor of outcome in first-episode psychosis.
- The extent to which DUP's effects are mediated by other factors remains unclear.
- This study investigates DUP's independent impact on 12-month outcomes.
Purpose of the Study:
- To determine the specific effects of DUP on 12-month outcomes in first-episode psychosis.
- To adjust for potential confounders and moderating variables influencing psychosis outcome.
- To assess DUP's predictive power independently of other known prognostic factors.
Main Methods:
- A cohort of 354 first-episode psychosis patients was followed for 12 months post-stabilization.
- Outcome measures included functional outcome, positive symptom severity, and negative symptom severity.
- Hierarchical multiple regression and contrast analysis were used to evaluate DUP's predictive significance.
Main Results:
- DUP remained a significant predictor of 12-month outcome, even after adjusting for other variables.
- Functional outcome declined significantly with DUP exceeding 7 days and showed gradual deterioration beyond 1 year.
- Positive predictors of good outcome included good pre-morbid adjustment, female gender, affective disorder diagnosis, and early intervention models.
Conclusions:
- DUP independently predicts outcomes in first-episode psychosis and is not merely a proxy for other variables.
- DUP is a crucial, modifiable factor that can be targeted for secondary prevention in early psychosis interventions.
- Early intervention for psychosis is critical to mitigate the negative impact of prolonged DUP on patient functioning.