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Prognostic value of duration of untreated psychosis in long-term outcome of schizophrenia.

Cechnicki A, Hanuszkiewicz I, Polczyk R, Bielańska A - Med. Sci. Monit. (2011)

Bottom Line: DUP information was obtained by clinical interview with patients and their families.Decreases in the results of BPRS (symptom improvement) were more prominent in patients with a shorter DUP.The latter had significantly lower results than patients with a long DUP at each assessment except the index hospitalization (p equalled, respectively: 0.449; 0.002; 0.012; 0.034 and 0.014).

View Article: PubMed Central - PubMed

Affiliation: Community Psychiatry Unit, Chair of Psychiatry, Collegium Medicum, Jagiellonian University, Cracow, Poland. mzcechni@cyf-kr.edu.pl

ABSTRACT

Background: The goal of this prognostic study was to investigate whether the duration of untreated psychosis (DUP) may have a prognostic value with regard to the further course of the illness.

Material/methods: Fifty-eight patients (77% of the original study group) diagnosed with DSM III schizophrenia and later re-diagnosed with DSM IV T-R were assessed at 4 time points. Number of relapses, average time of inpatient treatment, number of inpatient readmissions, and severity of psychopathological symptoms were assessed at 1-, 3-, 7- and 12-year follow-ups. DUP information was obtained by clinical interview with patients and their families. The severity of symptoms was assessed using BPRS-SA, UCLA version.

Results: Increases in the number of relapses at follow-ups were more prominent in the group with a longer DUP (p<0.001). Decreases in the results of BPRS (symptom improvement) were more prominent in patients with a shorter DUP. The latter had significantly lower results than patients with a long DUP at each assessment except the index hospitalization (p equalled, respectively: 0.449; 0.002; 0.012; 0.034 and 0.014). Decreases in positive symptoms were greater in patients with a short DUP--significant at all except the 7-year follow-up (p equalled respectively: 0.230; <0.001; 0.011; 0.214; <0.001).

Conclusions: 1) A positive correlation was found between DUP and the dynamics of general and positive symptoms and the number of relapses. 2) There was no significant relationship between DUP and the dynamics of negative symptoms, whereas the relationship between the time and number of re-hospitalizations was marginally significant.

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Related in: MedlinePlus

Dynamics of global psychopathology, positive and negative syndrome in BPRS.
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f4-medscimonit-17-5-cr277: Dynamics of global psychopathology, positive and negative syndrome in BPRS.

Mentions: The results shown in Table 3 show that the dynamic was statistically significant for all the 3 indices of the BPRS. Figure 4 shows that all parameters decreased with time. The most noticeable decrease of the investigated parameters occurred between index hospitalization and discharge. Subsequently, between discharge and the 12-year follow-up, the changes were slight. This observation, however, refers to the analysis that does not take into account the impact of the DUP.


Prognostic value of duration of untreated psychosis in long-term outcome of schizophrenia.

Cechnicki A, Hanuszkiewicz I, Polczyk R, Bielańska A - Med. Sci. Monit. (2011)

Dynamics of global psychopathology, positive and negative syndrome in BPRS.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539595&req=5

f4-medscimonit-17-5-cr277: Dynamics of global psychopathology, positive and negative syndrome in BPRS.
Mentions: The results shown in Table 3 show that the dynamic was statistically significant for all the 3 indices of the BPRS. Figure 4 shows that all parameters decreased with time. The most noticeable decrease of the investigated parameters occurred between index hospitalization and discharge. Subsequently, between discharge and the 12-year follow-up, the changes were slight. This observation, however, refers to the analysis that does not take into account the impact of the DUP.

Bottom Line: DUP information was obtained by clinical interview with patients and their families.Decreases in the results of BPRS (symptom improvement) were more prominent in patients with a shorter DUP.The latter had significantly lower results than patients with a long DUP at each assessment except the index hospitalization (p equalled, respectively: 0.449; 0.002; 0.012; 0.034 and 0.014).

View Article: PubMed Central - PubMed

Affiliation: Community Psychiatry Unit, Chair of Psychiatry, Collegium Medicum, Jagiellonian University, Cracow, Poland. mzcechni@cyf-kr.edu.pl

ABSTRACT

Background: The goal of this prognostic study was to investigate whether the duration of untreated psychosis (DUP) may have a prognostic value with regard to the further course of the illness.

Material/methods: Fifty-eight patients (77% of the original study group) diagnosed with DSM III schizophrenia and later re-diagnosed with DSM IV T-R were assessed at 4 time points. Number of relapses, average time of inpatient treatment, number of inpatient readmissions, and severity of psychopathological symptoms were assessed at 1-, 3-, 7- and 12-year follow-ups. DUP information was obtained by clinical interview with patients and their families. The severity of symptoms was assessed using BPRS-SA, UCLA version.

Results: Increases in the number of relapses at follow-ups were more prominent in the group with a longer DUP (p<0.001). Decreases in the results of BPRS (symptom improvement) were more prominent in patients with a shorter DUP. The latter had significantly lower results than patients with a long DUP at each assessment except the index hospitalization (p equalled, respectively: 0.449; 0.002; 0.012; 0.034 and 0.014). Decreases in positive symptoms were greater in patients with a short DUP--significant at all except the 7-year follow-up (p equalled respectively: 0.230; <0.001; 0.011; 0.214; <0.001).

Conclusions: 1) A positive correlation was found between DUP and the dynamics of general and positive symptoms and the number of relapses. 2) There was no significant relationship between DUP and the dynamics of negative symptoms, whereas the relationship between the time and number of re-hospitalizations was marginally significant.

Show MeSH
Related in: MedlinePlus