Duration of untreated psychosis is associated with more negative schizophrenia symptoms after acute treatment for first-episode psychosis

The abstract of an article published in the March 1st edition of
Clinical Psychologist:

Abstract

By Niklas Granö, Jenni Lindsberg, Marjaana Karjalainen, Peter Grönroos, and Ari-Pekka Blomberg

Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients. The sample included 41 first-episode patients who had an ICD-10 schizophrenia spectrum diagnosis (F20-F29) and were treated with antipsychotic medication. Longer duration in days from the first psychotic symptoms to the initiation of antipsychotic medication had a statistically significant positive correlation with mean level of negative symptoms (Spearman's ρ = .38; p < .05). Results suggests that DUP is associated with a higher level of negative symptoms after the onset of adequate antipsychotic treatment. This should be considered in the care of FEP.

Keywords: duration of untreated psychosis; first-episode psychosis; negative symptoms

Posting of this abstract is for the purposes of research into psychosis and schizophrenia.

Beyond the critical period: longitudinal study of 8-year outcome in first-episode non-affective psychosis

An abstract published in the January 1st edition of the British Journal of Psychiatry by Crumlish et al.:

Background

The critical period hypothesis proposes that deterioration occurs aggressively during the early years of psychosis, with relative stability subsequently. Thus, interventions that shorten the duration of untreated psychosis (DUP) and arrest early deterioration may have long-term benefits.

Aims

To test the critical period hypothesis by determining whether outcome in non-affective psychosis stabilises beyond the critical period and whether DUP correlates with 8-year outcome; to determine whether duration of untreated illness (DUI) has any independent effect on outcome.

Method

We recruited 118 people consecutively referred with first-episode psychosis to a prospective, naturalistic cohort study.

Results

Negative and disorganised symptoms improved between 4 and 8 years. Duration of untreated psychosis predicted remission, positive symptoms and social functioning at 8 years. Continuing functional recovery between 4 and 8 years was predicted by DUI.

Conclusions

These results provide qualified support for the critical period hypothesis. The critical period could be extended to include the prodrome as well as early psychosis.