Duration of untreated psychosis and its correlates in first‐episode psychosis in Finland and Spain

Kalla, Outi; Aaltonen, Jukka; Wahlström, Jarl; Lehtinen, Ville; Cabeza, Ignacio García; Chávez, Manuel González de

doi:10.1034/j.1600-0447.2002.02302.x

Cited by 85 publications

(64 citation statements)

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“…Proxy measures of poor pre-morbid functioning (being single, being unemployed) and at-risk behaviour (criminal behaviour, substance use) were associated with longer delays between first psychotic symptoms and first helping contact, first treatment or first admission. These results are in accordance with the findings of previous studies exploring the characteristics associated with longer access to care (Larsen et al 1998 ;Verdoux et al 1998bVerdoux et al , 2001Norman & Malla, 2001 ;Kalla et al 2002). Poor pre-morbid functioning may delay the first helping contact attempt because subjects presenting with this characteristic are less likely to be detected and helped by their circle of relatives, friends and acquaintances than those with adequate social functioning (Cole et al 1995 ;Larsen et al 1998 ;Barnes et al 2000;Drake et al 2000).…”

Section: Interpretation Of Findingssupporting

confidence: 95%

Pathways to care of first-admitted subjects with psychosis in South-Western France

et al. 2004

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Section: Interpretation Of Findingssupporting

confidence: 95%

Pathways to care of first-admitted subjects with psychosis in South-Western France

et al. 2004

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“…Clinical data were collected from clinical records of the Outpatient Clinics for Drug Resistance at the Department of Neuroscience, including also patient family interviews, and the duration of psychosis (disease duration—DD) and the duration of untreated psychosis were calculated from the first manifestation of psychotic symptoms such as delusions, hallucinations, thought disorder, or inappropriate/bizarre behavior lasting throughout the day for several days or several times a week and requiring an unambiguous psychiatric intervention [26]. …”

Section: Methodsmentioning

confidence: 99%

Patients with Poor Response to Antipsychotics Have a More Severe Pattern of Frontal Atrophy: A Voxel-Based Morphometry Study of Treatment Resistance in Schizophrenia

Quarantelli

Palladino

Prinster

et al. 2014

BioMed Research International

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Approximately 30% of schizophrenia patients do not respond adequately to the therapy. Previous MRI studies have suggested that drug treatment resistance is associated with brain morphological abnormalities, although region-of-interest analysis of MR studies from nonresponder and responder patients failed to demonstrate a statistically significant difference between these two schizophrenia subgroups. We have used a voxel-based analysis of segmented MR studies to assess structural cerebral differences in 20 nonresponder and 15 responder patients and 16 age-matched normal volunteers. Differences between the three groups emerged bilaterally mainly at the level of the superior and middle frontal gyri, primarily due to reduced grey matter volumes in nonresponders, as compared to both normal volunteers and responder patients. Post hoc direct comparison between the two schizophrenia subgroups demonstrated significantly reduced grey matter volumes in middle frontal gyrus bilaterally, in the dorsolateral aspects of left superior frontal gyrus extending into postcentral gyrus and in the right medial temporal cortex. Our results extend and integrate previous findings suggesting a more severe atrophy in nonresponder schizophrenia patients, compared to responder patients, mainly at the level of the superior and middle frontal gyri. Longitudinal studies in drug-naïve patients are needed to assess the role of these associations.

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“…For long-term outcome, some longitudinal studies have shown that the effect of DUP is not as great as the previously believed [11]. As regard MoO, insidious onset has been suggested to be related with unfavorable outcome [12], [13]. Accumulating evidence of these two factors (DUP and MoO) indicates that their numeric values were not only clinical usefulness, but also that onset pattern could have great effects on the etiology occurring prior to treatment intervention and further consequent disease course.…”

Section: Introductionmentioning

confidence: 98%

Onset Pattern and Long-Term Prognosis in Schizophrenia: 10-Year Longitudinal Follow-Up Study

et al. 2013

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BackgroundAlthough the duration of untreated psychosis (DUP) plays an important role in the short-term prognosis of patients with schizophrenia, their long-term prognosis generally is not determined by DUP alone. It is important to explore how other clinical factors in the early stage are related to DUP and consequent disease courses.MethodsA total of 664 patients with untreated psychosis were surveyed for this study. At the first examination, we divided them into the severe positive symptoms cases (SC) or the less severe cases (NonSC) and compared the prognosis among the two groups after a 10-year follow-up. In all, 113 patients in the SC group and 43 patients in the NonSC group were follow-up completers.ResultsWhereas DUP was not different between the two groups, patients with nonacute onset in both groups had significantly longer DUP than those in patients with acute onset. For all clinical measures, there was no difference in prognosis between the two groups or among the four groups classified by mode of onset (MoO) and initial severity of positive symptoms. However, the degree of improvement of global assessment of functioning (GAF) was significantly smaller in the NonSC-nonacute group than in the SC-acute and SC-nonacute groups.ConclusionsThese results suggest that neither DUP nor MoO alone necessarily affects the initial severity of positive symptoms. Moreover, it is possible that patients with low impetus of positive symptoms onset within long DUP experience profound pathologic processes. Therefore, the current study results indicated that long DUP and nonacute onset were related to poor long-term prognosis, regardless of initial positive symptoms.

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Duration of untreated psychosis and its correlates in first‐episode psychosis in Finland and Spain

Abstract: There are universal psychosocial factors influencing DUP, but also cultural differences may have an impact on the treatment delay.

Cited by 85 publications

References 44 publications

Pathways to care of first-admitted subjects with psychosis in South-Western France

Pathways to care of first-admitted subjects with psychosis in South-Western France

Patients with Poor Response to Antipsychotics Have a More Severe Pattern of Frontal Atrophy: A Voxel-Based Morphometry Study of Treatment Resistance in Schizophrenia

Onset Pattern and Long-Term Prognosis in Schizophrenia: 10-Year Longitudinal Follow-Up Study

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