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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- 作者：David Fraguas ; 脕ngel del Rey-Mej铆as ; Carmen Moreno ; Josefina Castro-Fornieles ; Montserrat Graell ; Soraya Otero ; Ana Gonzalez-Pinto ; Dolores Moreno ; Inmaculada Baeza ; M贸nica Mart铆nez-Cengotitabengoa ; Celso Arango ; Mara Parellada
- 关键词：Duration of untreated psychosis (DUP) ; First-episode psychosis (FEP) ; Schizophrenia ; Bipolar disorder ; Affective psychosis ; Adolescent ; Outcome ; Remission
- 刊名：Schizophrenia Research
- 出版年：January, 2014
- 年：2014
- 卷：152
- 期：1
- 页码：130-138
- 全文大小：556 K
文摘
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 卤 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 卤 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 = 鈭?#xA0;0.13, p < 0.01), while DUP and premorbid adjustment (Beta = 鈭?#xA0;0.01, p < 0.01; and Beta = 鈭?#xA0;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.