Duration of untreated psychosis predicts functional and clinical outcome in children and adolescents with first-episode psychosis: A 2-year longitudinal study |
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| Affiliation: | 1. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain;2. Department of Child and Adolescent Psychiatry and Psychology, SGR-111, CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clínic of Barcelona, Spain;3. Department of Psychiatry and Psychobiology, University of Barcelona, Spain;4. Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain;5. Child Psychiatry Unit, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain;6. Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Vitoria, CIBERSAM, Spain;1. Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland;2. GfK Polonia, ul. Ludna 2, 00-406 Warsaw, Poland;3. University of Social Sciences and Humanities, ul. Kutrzeby 10, Poznan, Poland;1. Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain;2. Centro de Investigación Biomédica en Red de Salud Mental — CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain;3. National Distance Education University (UNED)-Centro Asociado de Vitoria, Spain;4. Neuropsychopharmacology and Psychobiology Research Group, University of Cadiz, Cadiz, Spain;5. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain;6. Medical School, Universidad Complutense, Madrid, Spain;7. Department of Child and Adolescent Psychiatry and Psychology, SGR-1119, Neurosciences Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain;8. Department of Psychiatry and Psychobiology, University of Barcelona, Spain;9. Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, Madrid, Spain;10. Child and Adolescent Psychiatry and Psychology Unit, University Hospital Marques de Valdecilla, Santander, Spain;11. Department of Pharmacology, Medical School, Universidad Complutense, Madrid, Spain;12. University of the Basque Country, Spain;13. Department of Psychiatry, Clinic Institute of Neurosciences, Hospital Clinic, Barcelona, Spain;1. Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong;2. State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong |
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| Abstract: | Longer duration of untreated psychosis (DUP) in adult patients with first-episode psychosis (FEP) has been associated with poor clinical and social outcomes. We aimed to estimate the influence of DUP on outcome at 2-year follow-up in subjects with an early-onset (less than 18 years of age) FEP of less than 6 months' duration. A total of 80 subjects (31.3% females, mean age 16.0 ± 1.8 years) were enrolled in the study. The influence of DUP on outcome was estimated using multiple regression models (two linear models for influence of DUP on the C-GAF at 2 years and C-GAF change through the follow-up period, and a logistic model for influence of DUP on 41 PANSS remission at 2 years in schizophrenia patients (n = 47)). Mean DUP was 65.3 ± 54.7 days. Median DUP was 49.5 days. For the whole sample (n = 80), DUP was the only variable significantly related to C-GAF score at 2-year follow-up (Beta = − 0.13, p < 0.01), while DUP and premorbid adjustment (Beta = − 0.01, p < 0.01; and Beta = − 0.09, p = 0.04, respectively) were the only variables significantly related to C-GAF change. In schizophrenia patients, DUP predicted both C-GAF score at 2 years and C-GAF change, while in patients with affective psychosis (n = 22), DUP was unrelated to outcome. Lower baseline C-GAF score (OR = 0.91, p < 0.01) and shorter DUP (OR = 0.98, p = < 0.01) were the only variables that significantly predicted clinical remission in schizophrenia patients. In conclusion, longer DUP was associated with lower C-GAF at 2 years, less increase in C-GAF, and lower rates of clinical remission in early-onset FEP. Our findings support the importance of early detection programs, which help shorten DUP. |
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