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Early Intervention in Psychosis: A Retrospective Analysis of Clinical and Social Factors Influencing Duration of Untreated Psychosis

Prim Care Companion J Clin Psychiatry 2009;11(5):212-214
10.4088/PCC.08m00705

Objective: To investigate the clinical and social factors determining the duration of untreated psychosis (DUP) in 2 groups of individuals with first-episode psychosis.

Method: Clinical and social variables were collected retrospectively from the case notes of 74 patients with first-episode psychosis (defined as 1 of the categories in the ICD-10 of psychotic episode arising from a functional or substance misuse cause). Patients were divided into 2 groups, one with a DUP less than 12 weeks (n = 46) and one with a DUP equal to or longer than 12 weeks (n = 28). The means, standard deviations, and medians were calculated for the total sample as well as for each group, and data from the 2 groups were compared to determine differences. The study was conducted from January 2006 to January 2008.

Results: Of the 74 patients, a longer DUP was significantly associated with being male (P = .025) and with having an insidious mode of onset (P < .001), comorbid substance misuse (P < .01), and less family support (P = .01). Conversely, shorter DUP was associated with acute presentation (P < .001).

Conclusions: These findings suggest that a longer DUP is influenced by the early clinical course and by social variables. Early recognition of these predictors of prolonged DUP should have an impact on reducing DUP and potentially improving the prognosis.