Does a detection team shorten duration of untreated psychosis?

Duration of untreated psychosis (DUP) is shown to be associated with poor outcome in many domains. It has been shown that it is possible to shorten DUP when combining a detection team and an information campaign. The aim of this study was to evaluate whether DUP was shortened during the first 3 years after establishing detection teams without a concomitant information campaign.

All patients included in the OPUS trial were examined with the Instrument for Retrospective Assessment of Onset of Psychosis to determine DUP. A total of 552 patients with first episode psychotic disorder (n=470) or schizotypal disorder (n=82) were included in the study. The 3-year inclusion period was divided into six consecutive periods of 6 months each.

The median DUP was 52 weeks. DUP was not significantly reduced during the 3-year inclusion period, but a larger proportion of patients with symptoms below the threshold for frank psychosis were included compared with the beginning of the trial. The proportion referred from primary care remained small (8-10%) and unchanged during the inclusion period.

The availability of a detection team increased the referral of patients with schizotypal disorder, but the DUP among psychotic patients remained almost unaltered throughout the period. It seems that an information campaign and possibilities for direct access and self-referral are necessary in order to shorten DUP.