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Untreated illness and outcome of psychosis

  • Mary Clarke (a1), Peter Whitty (a1), Stephen Browne (a1), Orfhlaith McTigue (a1), Moayyad Kamali (a1), Maurice Gervin (a1), Anthony Kinsella (a2), John L. Waddington (a3), Conal Larkin (a4) and Eadbhard O'Callaghan (a4)...

Abstract

Background

There has been controversy as to whether early intervention in psychosis can improve the outcome of the disorder.

Aims

To establish if there is an association between duration of untreated psychosis and the 4-year outcome of persons with a first episode of psychosis.

Method

Prospective naturalistic follow-up study of the outcome of consecutive first presentations with DSM–IV psychosis attending a community-based psychiatric service.

Results

A longer duration of untreated psychosis was associated with a significantly poorer functional and symptomatic outcome 4 years later. For schizophrenia and schizophreniform disorder, each increment in duration of untreated psychosis was associated with a 7.8 point decrease in global functioning and an increase in positive symptoms scores by 1.9 points.

Conclusions

This study extends the findings of short-term follow-up studies by confirming an association between duration of untreated psychosis and ‘midterm’ outcome.

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Copyright

Corresponding author

Professor Eadbhard O'Callaghan, DELTA/DETECT Early Intervention in Psychosis Services, 1 Marine Tec., Dun Laoghaire, Co. Dublin, Ireland. Tel: +353 12172100; fax: +353 1 2833886; email: eadbhard@gmail.com

Footnotes

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Declaration of interest

None. Funded by the Stanley Medical Research Institute.

Poster presentation at the 13th Biennial Winter Workshop on Schizophrenia, Davos, Switzerland, February 2004.

Footnotes

References

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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Barnes, T., Hutton, S., Chapman, M., et al (2000) West London first-episode study of schizophrenia: clinical correlates of duration of untreated psychosis. British Journal of Psychiatry, 177, 207211.
Beiser, M., Erickson, D., Fleming, J., et al (1993) Establishing the onset of psychotic illness. American Journal of Psychiatry, 158, 13491354.
Bottlender, R., Sato, T., Jager, M., et al (2003) The impact of duration of untreated psychosis prior to first admission on the 15-year outcome in schizophrenia. Schizophrenia Research, 62, 3744.
Browne, S., Clarke, M., Gervin, M., et al (2000) Determinants of neurological dysfunction in first episode schizophrenia. Psychological Medicine, 30, 14331441.
Carbone, S., Harrigan, S., McGorry, P. D., et al (1999) Duration of untreated psychosis and 12 month outcome in first episode psychosis: the impact of treatment approach. Acta Psychiatrica Scandinavica, 100, 96104.
Cohen, J. (1969) Statistical Power Analysis for the Behavioral Sciences. New York: Academic Press.
Craig, T., Bromet, E., Fennig, S., et al (2000) Is there an association between duration of untreated psychosis and 24-month clinical outcome in first admission series? American Journal of Psychiatry, 157, 6066.
First, M. B., Spitzer, R. L., Gibbon, M., et al (1995) Structured Clinical Interview for DSM–IV Axis I Disorders – Patient Edition (SCID I/P, Version 2.0). New York: New York State Psychiatric Institute.
Foerster, A., Lewis, S., Owen, M., et al (1991) Pre-morbid adjustment and personality in psychosis: effects of sex and diagnosis. British Journal of Psychiatry, 158, 171176.
Friis, S., Larsen, T. K., Melle, I., et al (2003) Methodological pitfalls in early detection studies – the NAPE Lecture 2002. Acta Psychiatrica Scandinavica, 107, 39.
Harrigan, S., McGorry, P. D. & Krstev, H. (2003) Does treatment delay in first episode psychosis really matter? Psychological Medicine, 33, 97110.
Ho, B. C., Andreasen, N., Flaum, M., et al (2000) Untreated initial psychosis: its relationship to quality of life and symptom remission in first episode schizophrenia. American Journal of Psychiatry, 157, 808815.
Kay, S. R., Opler, L. A. & Fiszbein, A. (1986) Positive and Negative Syndrome Scale (PANSS) Rating Manual. New York: Department of Psychiatry, Albert Einstein College of Medicine, Montefiore Medical Centre and Schizophrenia Research Unit.
Keshavan, M. S., Haas, G., Miewald, J., et al (2003) Prolonged untreated illness duration from prodromal onset predicts outcome in first episode psychoses. Schizophrenia Bulletin, 29, 757769.
Larsen, T. K., Moe, L. C., Vibe-Hansen, L., et al (2000) Premorbid functioning versus duration of untreated psychosis in 1 year outcome in first episode psychosis. Schizophrenia Research, 45, 19.
Loebel, A. D., Lieberman, J. A., Alvir, J. M., et al (1992) Duration of psychosis and outcome in firstepisode schizophrenia. American Journal of Psychiatry, 149, 11831188.
Malla, A. K., Norman, R. M. G., Manchanda, R., et al (2002) One year outcome in first episode psychosis: influence of DUP and other predictors. Schizophrenia Research, 54, 231242.
Marshall, M. & Lockwood, A. (2004) Early Intervention for Psychosis. Cochrane Data base of Systematic Reviews, 2: CD004718.
Melle, I., Larsen, T. K., Haahr, U., et al (2004) Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Archives of General Psychiatry, 61, 143150.
Norman, R. M. & Malla, A. K. (2001) Duration of untreated psychosis: a critical examination of the concept and its importance. Psychological Medicine, 31, 381400.
Robinson, D., Woerner, M. G., Alvir, J. M., et al (1999) Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Archives of General Psychiatry, 56, 241247.
Whitty, P., Browne, S., Clarke, M., et al (2005) Systematic comparison of subjective and objective measures of quality of life at 4-year follow-up subsequent to a first episode of psychosis. Journal of Nervous and Mental Disease, 192, 805809.
Wiermsa, D., Nienhuls, F., Slooff, C. J., et al (1998) Natural course of schizophrenic disorders: a 15 year follow-up of a Dutch incidence cohort. Schizophrenia Bulletin, 24, 7585.

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Untreated illness and outcome of psychosis

  • Mary Clarke (a1), Peter Whitty (a1), Stephen Browne (a1), Orfhlaith McTigue (a1), Moayyad Kamali (a1), Maurice Gervin (a1), Anthony Kinsella (a2), John L. Waddington (a3), Conal Larkin (a4) and Eadbhard O'Callaghan (a4)...

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Untreated illness and outcome of psychosis

  • Mary Clarke (a1), Peter Whitty (a1), Stephen Browne (a1), Orfhlaith McTigue (a1), Moayyad Kamali (a1), Maurice Gervin (a1), Anthony Kinsella (a2), John L. Waddington (a3), Conal Larkin (a4) and Eadbhard O'Callaghan (a4)...
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