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Duration of untreated prodromal symptoms in a Chinese sample at a high risk for psychosis: demographic, clinical, and outcome

Published online by Cambridge University Press:  27 November 2017


TianHong Zhang
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, PR China
LiHua Xu
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
YingYing Tang
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, PR China
HuiRu Cui
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
YanYan Wei
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
JunJie Wang
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
XiaoChen Tang
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
ChunBo Li
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
JiJun Wang
Affiliation:
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, PR China
Corresponding
E-mail address:

Abstract

Background

The duration of untreated psychosis (DUP) has been widely studied. However, for individuals with attenuated psychosis syndrome (APS), it is unclear whether the duration of untreated prodromal symptoms (DUPrS) also has a negative effect on the progression of psychosis. Our aim was to identify demographic and clinical factors contributing to the DUPrS in a large sample of individuals with APS, and to evaluate the association between DUPrS and the conversion to psychosis.

Method

A sample of 391 individuals with APS, who were identified through a structured interview for prodromal syndromes, were included in this study, of whom a total of 334 patients had completed at least a 1-year clinical follow-up. A total of 57 individuals had converted to psychosis.

Results

The average DUPrS was 4.8 months for the whole sample. Individuals with a longer DUPrS were likely to be men, non-local residents, with abnormal thought symptoms, a higher severity level of negative symptoms, the lower severity level of general symptoms, and lower level of general function before the onset of attenuated positive symptoms. A DUPrS of less than 2 months, or more than 6 months, lowered the risk for conversion to psychosis.

Conclusions

Our data suggested that the association between the DUPrS and outcome in individuals with APS were likely to be different, which is either long or short DUPrS was not related to future psychosis onset. Individuals with APS were more likely to have a group of features associated with a longer DUPrS.


Type
Original Articles
Copyright
Copyright © Cambridge University Press 2017 

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References

Apeldoorn, SY, Sterk, B, van den Heuvel, ER, Schoevers, RA, Islam, MA, Genetic, R, Outcome of Psychosis I, Bruggeman, R, Cahn, W, deHaan, L, Kahn, RS, Meijer, CJ, Myin-Germeys, I, van Os, J and Wiersma, D (2014) Factors contributing to the duration of untreated psychosis. Schizophrenia Research 158, 7681.CrossRefGoogle ScholarPubMed
Bay, N, Bjornestad, J, Johannessen, JO, Larsen, TK and Joa, I (2016) Obstacles to care in first-episode psychosis patients with a long duration of untreated psychosis. Early Intervention in Psychiatry 10, 7176.CrossRefGoogle ScholarPubMed
Birnbaum, ML, Wan, CR, Broussard, B and Compton, MT (2017) Associations between duration of untreated psychosis and domains of positive and negative symptoms. Early Intervention in Psychiatry 11, 375382.Google ScholarPubMed
Boonstra, N, Klaassen, R, Sytema, S, Marshall, M, De Haan, L, Wunderink, L and Wiersma, D (2012) Duration of untreated psychosis and negative symptoms--a systematic review and meta-analysis of individual patient data. Schizophrenia Research 142, 1219.CrossRefGoogle ScholarPubMed
Carpenter, WT and Schiffman, J (2015) Diagnostic concepts in the context of clinical high risk/attenuated psychosis syndrome. Schizophrenia Bulletin 41, 10011002.CrossRefGoogle ScholarPubMed
Carrion, RE, Demmin, D, Auther, AM, McLaughlin, D, Olsen, R, Lencz, T, Correll, CU and Cornblatt, BA (2016) Duration of attenuated positive and negative symptoms in individuals at clinical high risk: associations with risk of conversion to psychosis and functional outcome. Journal of Psychiatric Research 81, 95101.Google ScholarPubMed
Chang, WC, Tang, JY, Hui, CL, Chiu, CP, Lam, MM, Wong, GH, Chung, DW, Law, CW, Tso, S, Chan, KP, Hung, SF and Chen, EY (2011) Gender differences in patients presenting with first-episode psychosis in HongKong: a three-year follow up study. The Australian and New Zealand Journal of Psychiatry 45, 199205.CrossRefGoogle ScholarPubMed
Chon, MW, Lee, TY, Kim, SN, Huh, MJ, Park, HY, Lee, CR, Shin, NY and Kwon, JS (2015) Factors contributing to the duration of untreated prodromal positive symptoms in individuals at ultra-high risk for psychosis. Schizophrenia Research 162, 6466.CrossRefGoogle ScholarPubMed
Compton, MT, Bakeman, R, Alolayan, Y, Balducci, PM, Bernardini, F, Broussard, B, Crisafio, A, Cristofaro, S, Amar, P, Johnson, S and Wan, CR (2015) Personality domains, duration of untreated psychosis, functioning, and symptom severity in first-episode psychosis. Schizophrenia Research 168, 113119.CrossRefGoogle ScholarPubMed
Compton, MT, Gordon, TL, Goulding, SM, Esterberg, ML, Carter, T, Leiner, AS, Weiss, PS, Druss, BG, Walker, EF and Kaslow, NJ (2011) Patient-level predictors and clinical correlates of duration of untreated psychosis among hospitalized first-episode patients. The Journal of Clinical Psychiatry 72, 225232.CrossRefGoogle ScholarPubMed
Cotton, SM, Wright, A, Harris, MG, Jorm, AF and McGorry, PD (2006) Influence of gender on mental health literacy in young Australians. The Australian and New Zealand Journal of Psychiatry 40, 790796.CrossRefGoogle ScholarPubMed
Crumlish, N, Whitty, P, Clarke, M, Browne, S, Kamali, M, Gervin, M, McTigue, O, Kinsella, A, Waddington, JL, Larkin, C and O'Callaghan, E (2009) Beyond the critical period: longitudinal study of 8-year outcome in first-episode non-affective psychosis. The British Journal of Psychiatry 194, 1824.CrossRefGoogle ScholarPubMed
Drake, RJ, Haley, CJ, Akhtar, S and Lewis, SW (2000) Causes and consequences of duration of untreated psychosis in schizophrenia. The British Journal of Psychiatry 177, 511515.CrossRefGoogle ScholarPubMed
Fridgen, GJ, Aston, J, Gschwandtner, U, Pflueger, M, Zimmermann, R, Studerus, E, Stieglitz, RD and Riecher-Rossler, A (2013) Help-seeking and pathways to care in the early stages of psychosis. Social Psychiatry and Psychiatric Epidemiology 48, 10331043.CrossRefGoogle Scholar
Fusar-Poli, P, Meneghelli, A, Valmaggia, L, Allen, P, Galvan, F, McGuire, P and Cocchi, A (2009) Duration of untreated prodromal symptoms and 12-month functional outcome of individuals at risk of psychosis. The British Journal of Psychiatry 194, 181182.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, Nelson, B, Valmaggia, L, Yung, AR and McGuire, PK (2014) Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophrenia Bulletin 40, 120131.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, Tantardini, M, De Simone, S, Ramella-Cravaro, V, Oliver, D, Kingdon, J, Kotlicka-Antczak, M, Valmaggia, L, Lee, J, Millan, MJ, Galderisi, S, Balottin, U, Ricca, V and McGuire, P (2017) Deconstructing vulnerability for psychosis: meta-analysis of environmental risk factors for psychosis in subjects at ultra high-risk. European Psychiatry 40, 6575.Google ScholarPubMed
Hartmann, JA, Yuen, HP, McGorry, PD, Yung, AR, Lin, A, Wood, SJ, Lavoie, S and Nelson, B (2016) Declining transition rates to psychotic disorder in ‘ultra-high risk’ clients: investigation of a dilution effect. Schizophrenia Research 170, 130136.CrossRefGoogle Scholar
Kake, TR, Garrett, N and Te Aonui, M (2016) Cognitive neuropsychological functioning in New Zealand Maori diagnosed with schizophrenia. The Australian and New Zealand Journal of Psychiatry 50, 566576.Google ScholarPubMed
Kane, JM, Robinson, DG, Schooler, NR, Mueser, KT, Penn, DL, Rosenheck, RA, Addington, J, Brunette, MF, Correll, CU, Estroff, SE, Marcy, P, Robinson, J, Meyer-Kalos, PS, Gottlieb, JD, Glynn, SM, Lynde, DW, Pipes, R, Kurian, BT, Miller, AL, Azrin, ST, Goldstein, AB, Severe, JB, Lin, H, Sint, KJ, John, M and Heinssen, RK (2016) Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. The American Journal of Psychiatry 173, 362372.Google ScholarPubMed
Loewy, RL, Bearden, CE, Johnson, JK, Raine, A and Cannon, TD (2005) The prodromal questionnaire (PQ): preliminary validation of a self-report screening measure for prodromal and psychotic syndromes. Schizophrenia Research 79, 117125.CrossRefGoogle ScholarPubMed
Lunsford-Avery, J. R., Goncalves, B. D., Brietzke, E., Bressan, R. A., Gadelha, A., Auerbach, R. P., Mittal, V. A. (2017) Adolescents at clinical-high risk for psychosis: circadian rhythm disturbances predict worsened prognosis at 1-year follow-up. Schizophrenia Research (in press).Google ScholarPubMed
Marshall, M, Lewis, S, Lockwood, A, Drake, R, Jones, P and Croudace, T (2005) Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Archives of General Psychiatry 62, 975983.CrossRefGoogle ScholarPubMed
McGlashan, T, Walsh, B, Woods, S (2010) The Psychosis-Risk Syndrome: Handbook for Diagnosis and Follow-Up. New York: Oxford University Press.Google Scholar
Miller, TJ, McGlashan, TH, Rosen, JL, Cadenhead, K, Cannon, T, Ventura, J, McFarlane, W, Perkins, DO, Pearlson, GD and Woods, SW (2003) Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophrenia Bulletin 29, 703715.CrossRefGoogle ScholarPubMed
Miller, TJ, McGlashan, TH, Rosen, JL, Somjee, L, Markovich, PJ, Stein, K and Woods, SW (2002) Prospective diagnosis of the initial prodrome for schizophrenia based on the structured interview for prodromal syndromes: preliminary evidence of interrater reliability and predictive validity. The American Journal of Psychiatry 159, 863865.CrossRefGoogle ScholarPubMed
Mittal, VA, Dean, DJ, Bernard, JA, Orr, JM, Pelletier-Baldelli, A, Carol, EE, Gupta, T, Turner, J, Leopold, DR, Robustelli, BL and Millman, ZB (2014) Neurological soft signs predict abnormal cerebellar-thalamic tract development and negative symptoms in adolescents at high risk for psychosis: a longitudinal perspective. Schizophrenia Bulletin 40, 12041215.CrossRefGoogle ScholarPubMed
Murru, A and Carpiniello, B (2016) Duration of untreated illness as a key to early intervention in schizophrenia: a review. Neuroscience Letters (in press).Google ScholarPubMed
Norman, RM, Lewis, SW and Marshall, M (2005) Duration of untreated psychosis and its relationship to clinical outcome. The British Journal of Psychiatry. Supplement 48, s19s23.CrossRefGoogle ScholarPubMed
Penttila, M, Jaaskelainen, E, Hirvonen, N, Isohanni, M and Miettunen, J (2014) Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis. The British Journal of Psychiatry 205, 8894.CrossRefGoogle ScholarPubMed
Perkins, DO, Gu, H, Boteva, K and Lieberman, JA (2005) Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. The American Journal of Psychiatry 162, 17851804.CrossRefGoogle ScholarPubMed
Qin, H, Zhang, J, Wang, Z, Min, H, Yan, C, Chen, F, Fu, W and Zhang, M (2014) Duration of untreated psychosis and clinical outcomes of first-episode schizophrenia: a 4-year follow-up study. Shanghai Archives Psychiatry 26, 4248.Google ScholarPubMed
Stafford, MR, Jackson, H, Mayo-Wilson, E, Morrison, AP and Kendall, T (2013) Early interventions to prevent psychosis: systematic review and meta-analysis. British Medical Journal 346, f185.CrossRefGoogle ScholarPubMed
Sterk, B, Slief, EM, Blankers, M, Linszen, DH and de Haan, L (2010) Duration of untreated psychosis and ethnicity. Schizophrenia Research 124, 238239.CrossRefGoogle ScholarPubMed
Valmaggia, LR, Byrne, M, Day, F, Broome, MR, Johns, L, Howes, O, Power, P, Badger, S, Fusar-Poli, P and McGuire, PK (2015) Duration of untreated psychosis and need for admission in patients who engage with mental health services in the prodromal phase. The British Journal of Psychiatry 207, 130134.CrossRefGoogle ScholarPubMed
Wang, J, Jiang, K, Zhang, T, Li, H, Woodberry, K and Seidman, L (2013) How should we intervene in psychosis risk syndromes? Shanghai Archives Psychiatry 25, 69.Google ScholarPubMed
Xu, L, Zhang, T, Zheng, L, Li, H, Tang, Y, Luo, X, Sheng, J and Wang, J (2016) Psychometric properties of prodromal questionnaire-brief version among Chinese help-seeking individuals. PLoS ONE 11, e0148935.Google ScholarPubMed
Yung, AR, Yuen, HP, Berger, G, Francey, S, Hung, TC, Nelson, B, Phillips, L and McGorry, P (2007) Declining transition rate in ultra high risk (prodromal) services: dilution or reduction of risk? Schizophrenia Bulletin 33, 673681.CrossRefGoogle ScholarPubMed
Zhang, T, Li, H, Woodberry, KA, Seidman, LJ, Zheng, L, Li, H, Zhao, S, Tang, Y, Guo, Q, Lu, X, Zhuo, K, Qian, Z, Chow, A, Li, C, Jiang, K, Xiao, Z and Wang, J (2014) Prodromal psychosis detection in a counseling center population in China: an epidemiological and clinical study. Schizophrenia Research 152, 391399.CrossRefGoogle Scholar
Zhang, TH, Li, HJ, Woodberry, KA, Xu, LH, Tang, YY, Guo, Q, Cui, HR, Liu, XH, Chow, A, Li, CB, Jiang, KD, Xiao, ZP, Seidman, LJ and Wang, JJ (2017) Two-year follow-up of a Chinese sample at clinical high risk for psychosis: timeline of symptoms, help-seeking and conversion. Epidemiology and Psychiatric Sciences 26, 287298.Google ScholarPubMed
Zheng, L, Wang, J, Zhang, T, Li, H, Li, C and Jiang, K (2012) The Chinese version of the SIPS/SOPS: a pilot study of reliability and validity. Chinese Mental Health Journal 26, 571576.Google Scholar

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