Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

Penttilä, Matti; Jääskeläinen, Erika; Hirvonen, Noora; Isohanni, Matti; Miettunen, Jouko

doi:10.1192/bjp.bp.113.127753

Cited by 574 publications

(426 citation statements)

References 42 publications

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“…The found value of 35.5 months for DUP is much higher compared to 14.1 months stated in a meta-analysis of mainly western studies and 20.7 months found by a retrospective assessment in a study done in neighbouring India 11,12 . But the association of longer DUP to lower functional scores were agreeing with many of the studies from west and India 1,2,11,12 .…”

Section: Discussionsupporting

confidence: 80%

“…This disorder is associated with occupational, academic and social functional impairment 1 . The cost of this decline in functioning is borne not only by the patient, but also by his or her family, community, and the government.…”

Section: Introductionmentioning

confidence: 99%

“…The duration of untreated psychosis (DUP) is the time period from the development of initial psychotic symptom, which is a delusion, a hallucination or formal thought disorder, to the beginning of adequate treatment 2 . Studies in the west have indicated that longer DUP is associated with poorer prognosis and functional level in later years of life 1 .Different factors such as social stigma, mental health literacy and accessibility to services could lead to delayed presentation of Schizophrenia 3 .…”

Section: Introductionmentioning

confidence: 99%

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Association of duration of untreated psychosis and functional level, in first episode of schizophrenia attendingan outpatient clinic in Sri Lanka

Chandradasa

Champika²,

Gunathillaka³

et al. 2016

J. Postgrad. Inst. Med.

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Schizophrenia is a progressive disorder that affects thoughts, emotions, perceptions and psychosocial behaviour. The duration of untreated psychosis (DUP) is the time period from development of initial psychotic symptom in the patient to the beginning of adequate treatment. Studies in the west have indicated that longer DUP is associated with poorer prognosis and functional level in schizophrenia. This study aimed to quantify the DUP retrospectively in a group of patients in their first episode of schizophrenia attending the outpatient psychiatry clinic of National Hospital of Sri Lanka. Their functional level was assessed using the modified general assessment of functioning scale (mGAF) prospectively over three months. The mean DUP was 35.5 months and a longer DUP was significantly associated with lower mGAF scores. This DUP is higher compared to western and Indian data, and indicates the need for early recognition and management.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of duration of untreated psychosis and functional level, in first episode of schizophrenia attendingan outpatient clinic in Sri Lanka

Chandradasa

Champika²,

Gunathillaka³

et al. 2016

J. Postgrad. Inst. Med.

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“…For example, longer duration of untreated psychosis (DUP) (Penttilä et al, 2014), family history of psychosis (Käkelä et al, 2014) and current substance use (Large, Mullin, Gupta, Harris, & Nielssen, 2014) all had small but significant association with poorer outcomes. These factors may be in interplay with one another.…”

Section: Discussionmentioning

confidence: 99%

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Immonen

Jääskeläinen

Korpela

et al. 2017

Early Intervention Psych

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226

116

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The aim of this study was to analyse the effect of age at onset on the long‐term clinical, social and global outcomes of schizophrenia through a systematic review and a meta‐analysis. Original studies were searched from Web of Science, PsycINFO, Pubmed and Scopus, as well as manually. Naturalistic studies with at least a 2‐year follow‐up were included. Of the 3509 search results, 81 articles fulfilled the inclusion criteria. The meta‐analysis was performed in Stata as a random‐effect analysis with correlation coefficients between age at onset and the outcomes (categorized into remission, relapse, hospitalization, positive symptoms, negative symptoms, total symptoms, general clinical outcome, employment, social/occupational functioning and global outcome). There was a statistically significant (P < .05) correlation between younger age at onset and more hospitalizations (number of studies, n = 9; correlation, r = 0.17; 95% confidence interval, CI 0.09–0.25), more negative symptoms (n = 7; r = 0.14; 95% CI 0.01–0.27), more relapses (n = 3; r = 0.11; 95% CI 0.02–0.20), poorer social/occupational functioning (n = 12; r = 0.15; 95% CI 0.05–0.25) and poorer global outcome (n = 13; r = 0.14; 95% CI 0.07–0.22). Other relationships were not significant. This was the first systematic review of the effects of age at onset on the long‐term outcomes of schizophrenia. The results show that age at onset has a small, but significant impact on some of the outcomes of schizophrenia.

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“…TGPS ile þizofreninin erken dönemdeki gidiþi arasýndaki iliþkiyi inceleyen araþtýrmalarýn çoðunda, TGPS uzadýkça tedavi yanýtýnýn daha sýnýrlý, alevlenmelerin daha sýk olduðu bildirilmiþtir (15). Ýzlem çalýþmalarý, TGPS'si daha uzun olan hastalarýn remisyona girme olasýlýðýnýn daha düþük olduðunu göster-miþtir (13,16). Ýlk atak psikoz hastalarýyla yapýlan uzunlamasýna bir izlem çalýþmasýnda, TGHS kýsa olanlarda ilk tedavi ile saðlanan düzelmenin 4. ve 8. yýllarda devam ettiði bulunmuþtur (5).…”

Section: Tgps'nin Prognoza Etkisiunclassified

The critical period in patients with psychosis: "Duration of Untreated Psychosis" and social determinants

Oruç¹,

Gültekin²

2018

J Clin Psy

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Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

Abstract: The small but mostly consistent correlation between long DUP and poor outcome indicates that early intervention in psychosis may have at least subtle positive effects on the long-term course of illness.

Cited by 574 publications

References 42 publications

Association of duration of untreated psychosis and functional level, in first episode of schizophrenia attendingan outpatient clinic in Sri Lanka

Association of duration of untreated psychosis and functional level, in first episode of schizophrenia attendingan outpatient clinic in Sri Lanka

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

The critical period in patients with psychosis: "Duration of Untreated Psychosis" and social determinants

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