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A, Malla A. Short duration of untreated psychosis enhances negative symptom remission in extended early intervention service for psychosis Objective: To test whether duration of untreated psychosis (DUP) < 3 months, recommended by the World Health Organization/ International Early Psychosis Association, enhances the effects of an extended early intervention service (EEIS) on symptom remission. Method: We examined data from a randomized controlled trial in which patients who received 2 years of treatment in EIS for psychosis were subsequently randomized to either 3 years of EEIS or 3 years of regular care (RC). Using a DUP cut-off ≤ 12 weeks (approximately < 3 months), patients were split into two groups. Length of positive, negative and total symptom remission were the outcomes. Results: Patients (N = 217) were mostly male (68%) with schizophrenia spectrum disorder (65%); 108 (50%) received EEIS (58 had DUP ≤12 weeks; 50 had DUP >12 weeks). Interaction between treatment condition (EEIS vs. RC) and DUP cut-off ≤ 12 weeks was only significant in multiple linear regression model examining length of negative symptom remission as the outcome (adjusted b = 36.88 [SE = 15.88], t = 2.32, P = 0.02). EEIS patients with DUP ≤12 weeks achieved 25 more weeks of negative symptom remission than EEIS patients with DUP >12 weeks. Conclusion: Having a short DUP may be critical in deriving long-term benefits from EIS for psychosis, including EEIS settings. This work empirically supports policy recommendations of reducing DUP <3 months. Significant outcomes• Having a short DUP of 12 weeks or less may increase the length of negative symptom remission by 25 more weeks among patients receiving treatment in an extended early intervention service for psychosis • These results are independent of known confounds including the age at onset of psychosis, premorbid functioning, having a diagnosis of schizophrenia spectrum disorder and the severity of negative symptoms at the time of randomization • This work provides important empirical support for the World Health Organization and International Early Psychosis Association's recommendation of having a DUP of less than 3 months in early intervention services for psychosis Limitations • Certain patient characteristics not included in this study (e.g. degree of insight and migration status) may have the potential to influence our findings.

Les diffé rences entre les sexes dans les ré sultats cliniques et fonctionnels de patients traité s dans un service d'intervention pré coce pour troubles psychotiques : une é tude par observation

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