Duration of untreated psychosis and outcome of schizophrenia: delay in intensive psychosocial treatment versus delay in treatment with antipsychotic medication

Abstract

Duration of untreated psychosis (DUP), defined as delay in treatment with antipsychotic medication, was found to be associated with an unfavorable course of schizophrenia. Delay in intensive psychosocial treatment (DIPT) may also be related to outcome. We examined the relationship of DUP and DIPT with several outcome domains 6 years after onset in a cohort of 88 consecutively admitted patients with early-onset schizophrenia and related disorders. Patients and their parents completed an inventory concerning DUP, DIPT, and various aspects of outcome. Psychotic relapse during the first year after hospitalization was assessed with a chart review. Both DUP and DIPT were found to be associated with negative symptoms at outcome; mode of onset was not. DUP was associated with mild psychotic relapse. DIPT was associated with months of rehospitalization. There was no relation between DUP or DIPT and other aspects of outcome. When we controlled for age at onset, gender, and duration of treated first psychotic episode, only DIPT was associated with negative symptoms at outcome. DIPT may be a more important predictor of negative symptoms at outcome than is delay in starting antipsychotic medication alone.