Duration of untreated psychosis and clinical outcome 1 year after first-episode psychosis

Abstract

Objective: The effectiveness of early intervention for patients with first-episode psychosis is uncertain. This study aimed to explore the association of duration of untreated psychosis and short-term clinical outcome. Patients and Methods: Ninety four patients receiving treatment from an early intervention programme in Hong Kong (the Early Assessment Service for Young People with First-episode Psychosis) were retrospectively assessed using a standardised survey to examine the relationship between duration of untreated psychosis and 1-year outcome variables such as treatment adherence, time to treatment response, and academic and occupational functioning. Results: Patients with a shorter duration of untreated psychosis had better treatment adherence and responded to treatment more quickly than patients with a longer duration of untreated psychosis. However, patients with a shorter duration of untreated psychosis were more likely to be admitted to hospital during their first psychotic episode. Duration of untreated psychosis was not related to the level of occupational functioning and the risk for relapse after stabilisation of first-episode psychosis. Conclusions: These findings suggest that patients with a shorter duration of untreated psychosis tend to present more acutely, yet have a faster rate of recovery, than patients with a longer duration of untreated psychosis. Duration of untreated psychosis has a significant effect on treatment adherence in the initial recovery phase. However, further studies are required to evaluate the relationship between duration of untreated psychosis and long-term outcome, as well as the impact of duration of untreated psychosis on the subsequent utilisation of health services. © 2005 Hong Kong College of Psychiatrists.