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. 2024 Dec 4;10(6):e216.
doi: 10.1192/bjo.2024.813.

The anomalous effect of COVID-19 pandemic restrictions on the duration of untreated psychosis

Jessica Nicholls-Mindlin  1 , Hadar Hazan  2 , Bin Zhou  3 , Fangyong Li  3 , Maria Ferrara  4 , Nina Levine  2 , Sarah Riley  2 , Sneha Karmani  2 , Walter S Mathis  2 , Matcheri S Keshavan  5 , Vinod H Srihari  2
Affiliations

The anomalous effect of COVID-19 pandemic restrictions on the duration of untreated psychosis

Jessica Nicholls-Mindlin et al. BJPsych Open. .

Abstract

We investigated the impact of COVID-19 restrictions on the duration of untreated psychosis (DUP). First-episode psychosis admissions (n = 101) to the STEP Clinic in Connecticut showed DUP reduction (P = 0.0015) during the pandemic, with the median reducing from 208 days pre-pandemic to 56 days in the early pandemic period, and subsequently increasing to 154 days (P = 0.0281). Time from psychosis onset to antipsychotic prescription decreased significantly in the pandemic (P = 0.0183), with the median falling from 117 to 35 days. This cohort study demonstrates an association between greater pandemic restrictions and marked DUP reduction, and provides insights for future early detection efforts.

Keywords: COVID 19; Psychotic disorders/schizophrenia; duration of untreated psychosis; first-episode psychosis; pathways to care.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Box and whisker plots of DUP-Total, DUP-Demand and DUP-Supply in the pre, early and late pandemic epochs. Box and whisker plots of log (DUP) in the pre-, early and late pandemic epochs for (a) DUP-Total (b) DUP-Demand and (c) DUP-Supply. The green line represents the log (median), the box represents the log (25th and 75th) percentiles, the whiskers represent the maximum and minimum below the upper and lower fence, and the red diamond represents the log (mean). The results of pairwise comparisons of pre-and early pandemic, and of early and late pandemic, are reported. DUP, duration of untreated psychosis; DUP-Demand, time in days between psychosis onset and first antipsychotic use; DUP-Supply, time in days between first antipsychotic use and enrolment into the programme; DUP-Total, time in days between psychosis onset and enrolment into the programme.
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