Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12 years.
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Authors
Hill, MicheleCrumlish, Niall
Clarke, Mary
Whitty, Peter
Owens, Elizabeth
Renwick, Laoise
Browne, Stephen
Macklin, Eric A
Kinsella, Anthony
Larkin, Conall
Waddington, John L
O'Callaghan, Eadbhard
Affiliation
Cluain Mhuire Family Centre, St John of God Adult Psychiatric Service, Co., Dublin, Ireland. michelehill1@gmail.comIssue Date
2012-11MeSH
AdolescentAdult
Chi-Square Distribution
Cohort Studies
Female
Humans
Male
Prognosis
Psychiatric Status Rating Scales
Psychopathology
Psychotic Disorders
Quality of Life
Retrospective Studies
Social Adjustment
Young Adult
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Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12 years. 2012, 141 (2-3):215-21 Schizophr. Res.Journal
Schizophrenia researchDOI
10.1016/j.schres.2012.08.013PubMed ID
23006501Abstract
The duration of untreated psychosis is well recognised as an independent predictor of symptomatic and functional outcome in the short term and has facilitated the development of worldwide early intervention programmes. However, the extent and mechanisms by which it might influence prognosis beyond a decade remain poorly understood.The authors examined the relationship between duration of untreated psychosis and outcome 12years after a first episode of psychosis and assessed whether its relationship with function is affected by symptoms in a prospective, 12-year follow-up of an epidemiologically-based inception cohort.
Longer duration of untreated psychosis predicted poorer remission status, more severe positive and negative symptoms, and greater impairment in general functioning, social functioning and quality of life at 12years on standardised measures, independent of other factors at baseline. It was not associated with gainful employment, for which education was the only predictor, or independent living, for which age was the only predictor. The relationship between duration of untreated psychosis and functional outcome was mediated by concurrent psychopathology, particularly negative symptoms.
These results provide qualified support for the potential long-term benefit of reduction in the duration of untreated psychosis in terms of improvement in symptoms and functional outcome. Its failure to predict real-life outcomes such as independent living and gainful employment could reflect the importance of pre-existing socio-cultural factors such as individual opportunity. The relationship between duration of untreated psychosis and negative symptoms was largely responsible for its effect on function, suggesting a possible long-term protective mechanism against disability.
Item Type
ArticleLanguage
enISSN
1573-2509ae974a485f413a2113503eed53cd6c53
10.1016/j.schres.2012.08.013