Duration of untreated psychosis: Relationship with baseline characteristics and three-year outcome in first-episode psychosis (original) (raw)
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Two-Year Clinical and Functional Outcomes of an Asian Cohort at Ultra-High Risk of Psychosis
Frontiers in Psychiatry, 2019
Background: To determine the 2-year clinical and functional outcomes of an Asian cohort at ultra-high risk (UHR) of psychosis. Method: This was a longitudinal study with a follow-up period of 2 years on 255 help-seeking adolescents and young adults at UHR of psychosis managed by a multidisciplinary mental health team in Singapore. Clients received case management, psychosocial, and pharmacological treatment as appropriate. Data comprising symptom and functional outcomes were collected over the observation period by trained clinicians and psychiatrists. Results: The 2-year psychosis transition rate was 16.9%, with a median time to transition of 168 days. After 2 years, 14.5% of the subjects had persistent at-risk symptoms while 7.5% developed other non-psychotic psychiatric disorders. 38.4% of the cohort had recovered and was discharged from mental health services. The entire cohort's functioning improved as reflected by an increase in the score of the Social and Occupational Functioning Assessment Scale during the follow-up period. Predictors to psychosis transition included low education level, baseline unemployment, a history of violence, and brief limited intermittent psychotic symptoms, while male gender predicted the persistence of UHR state, or the development of non-psychotic disorders. Conclusion: Use of the current UHR criteria allows us to identify individuals who are at imminent risk of developing not just psychosis, but also those who may develop other mental health disorders. Future research should include identifying the needs of those who do not transition to psychosis, while continuing to refine on ways to improve the UHR prediction algorithm for psychosis.
Shanghai archives of psychiatry, 2014
The relationship between the duration of untreated psychosis and long-term clinical outcomes remains uncertain. Prospectively assess the relationship of the duration of untreated psychosis on clinical outcomes in a sample of individuals with first-onset schizophrenia treated at the Pudong Mental Health Center from January 2007 to December 2008. Information about general health, psychotic symptoms and social functioning were collected using the Brief Psychiatric Rating Scale (BPRS), Treatment Emergent Symptom Scale (TESS), Morningside Rehabilitation Status Scale (MRSS), and Social Disability Screening Schedule (SDSS) at baseline and in June 2010 and June 2012. The 43 individuals with first-episode schizophrenia participating in the study were divided into short (<24 weeks) and long (>24weeks) duration of untreated psychosis (DUP) groups. The mean (sd) duration of follow-up was 1197 (401) days in the short DUP group and 1412 (306) days in the long DUP group (t=9.98, p=0.055). De...
Asia-pacific Psychiatry, 2010
Introduction: Duration of untreated psychosis (DUP) determines the outcome of schizophrenia. Previously, there was no information about the DUP among patients in Malaysia with schizophrenia. The aim of the present study was to investigate the association between DUP and patients' demographic, social cultural background and clinical features.Method: This is a cross-sectional study on patients who presented with first episode schizophrenia. Data from 74 primary care centers and hospitals between 1 January 2003 and 31 December 2007 were included in the analysis. All patients with first-episode schizophrenia were enrolled in the study.Results: The mean DUP was 37.6 months. The indigenous community appeared to have the shortest DUP compared to the Malay, Chinese and Indian communities. Female, people with lower educational level, and comorbidity with medical illness during contact had longer DUP.Discussion: DUP in this multiethnicity country was found to be significantly short among the indigenous people, which may sugest that traditional values and strong family and community ties shorten the DUP. Educational level may need to be further investigated, because as upgrading the general educational level could lead to shorter DUP among the patients as well.
Transition to psychosis: 6-month follow-up of a Chinese high-risk group in Hong Kong
Australian and New Zealand Journal of Psychiatry, 2006
Objectives: The identification of individuals at high risk of becoming psychotic within the near future creates opportunities for early intervention before the onset of psychosis. This study sets out to identify a group of symptomatic young people in a Chinese population with the high likelihood of transition to psychosis within a follow-up period of 6 months, and to determine the rate of transition to psychosis in this group. Method: Symptomatic individuals with a family history of psychotic disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were identified using the operationalized criteria of an ‘At Risk Mental State’. The individuals were prospectively assessed monthly on a measure of psychopathology for 6 months. Results: Eighteen out of 62 individuals (29%) made the transition to frank psychosis within a 6 month follow-up period, with the majority occurring within 3 months. In addition, significant differences were found in the intake Positive and ...
Duration of Untreated Psychosis and its Associated Factors
Objective: Early intervention is said to improve outcome in first episode psychosis, yet studies in developed countries have persistently found that many individuals with first episode psychosis delay significantly, before they access mental health services. Whether these findings apply to Malawi is not known. This study, therefore, aims to assess the average Duration of Untreated Psychosis (DUP), defined as the interval from first psychotic symptoms to first effective treatment, and assess factors that are associated with DUP in Mzuzu, Malawi. Methodology: The study was conducted in a catchment area with a population of 1,022,417. A total of 140 patients were recruited and assessed using Structured Clinical Interview for DSM-IV-TR (SCID), schedule for the assessment of positive and negative symptoms, Beiser Scale, and Global Assessment of Functioning (GAF) Scale. The data were analysed using Statistical Package for Social Sciences (SPSS). DUP was assessed using Beiser Scale, and in-depth interview from carers. Pearson Chi-square was used to analyse factors associated with DUP. Results: The mean DUP was 51.70 months. Low level of education, unemployment, diagnosis of schizophrenia, low GAF and negative symptoms were associated with a longer DUP. Most patients were assisted by family members in accessing services, and traditional healers were most commonly the first resource used. Those who first consulted traditional healers had a longer DUP than those who first consulted a health care service. Conclusion: The findings indicate that individuals with schizophrenia in Mzuzu have long Dup this could be due to difficulties in accessing health services and that several factors are associated with this delay.
Duration of untreated psychosis and average 13-year outcome in first admission schizophrenia
ombining retrospectively investigated duration of untreated psychosis (DUP) and data from the previously reported 13-year outcome study of first-admission schizophrenic patients treated in Jichi Medical University Hospital, relationship between DUP and 13-year outcome was examined. The mean DUP of 62 identified patients with schizophrenia was 8.7 months, and the median was one month. The 47 followed-up subjects were divided into two groups according to their rating on Eguma's Social Adjustment Scale: a favorable outcome group and an unfavorable outcome group. In addition, they were divided into other two groups according to length of DUP (cutoff point was two weeks): a brief DUP group and a long DUP group. However, no statistically significant relationship between both couple of groups was found, the long DUP patients tended to belong to the unfavorable group.
Early intervention versus standard care for psychosis in Hong Kong: a 10-year study
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2015
K e y M e s s a g e s 1. Psychotic patients who received early intervention had longer periods of employment, fewer hospitalisations, more time in symptomatic remission, fewer suicidal attempts and violent acts, and lower mortality over a 10-year period. 2. Early intervention improved the longitudinal outcomes of psychosis. Nonetheless, symptomatic remission and recovery rate did not differ significantly at 10 years between patients with early intervention and patients with standard care. Early intervention did not alter the symptomatic trajectory of schizophreniaspectrum disorders. 3. Re-examination of the optimum duration of early
Factors contributing to the duration of untreated psychosis
Schizophrenia Research, 2014
Background: Shortening the duration of untreated psychosis (DUP)with the aim of improving the prognosis of psychotic disordersrequires an understanding of the causes of treatment delay. Current findings concerning several candidate risk factors of a longer DUP are inconsistent. Our aim was to identify factors contributing to DUP in a large sample that represents the treated prevalence of non-affective psychotic disorders. Method: Patients with a non-affective psychotic disorder were recruited from mental health care institutes from 2004 to 2008. Of the 1120 patients enrolled, 852 could be included in the present analysis. Examined candidate factors were gender, educational level, migration status, premorbid adjustment and age at onset of the psychotic disorder. DUP was divided into five ordinal categories: less than one month, one month to three months, three months to six months, six months to twelve months and twelve months and over. An ordinal logistic regression analysis was used to identify the risk factors of a longer DUP. Results: Median DUP was less than one month (IQR 2). The factors migration status (p = 0.028), age at onset of the psychotic disorder (p = 0.003) and gender (p = 0.034) were significantly associated with DUP in our analysis. Conclusion: First generation immigrant patients, patients with an early onset of their psychotic disorder and male patients seem at risk of a longer DUP. These findings can assist in designing specific interventions to shorten treatment delay.