Correlation between duration of untreated psychosis and long-term prognosis in chronic schizophrenia

Abstract

ObjectiveTo explore the relationship between the Duration of Untreated Psychosis (DUP) and long-term clinical outcome, cognitive and social function in patients with chronic schizophrenia (SCZ).MethodsA total of 248 subjects with chronic SCZ were enrolled in this study, including 156 in the short DUP group and 92 in the long DUP group. The Positive and Negative Symptoms Scale (PANSS), the Brief Negative Symptoms Scale (BNSS), the Global Assessment of Functioning (GAF) scale and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess all of the subjects.ResultsThe negative symptom scores (the PANSS and BNSS) of subjects with long DUP were significantly higher than that in subjects with short DUP. The scores of visual span and speech function in the short DUP group were significantly higher, indicative of decreasing cognitive function with time. In terms of social function, the short DUP group scored higher, with a statistically significant difference. Meanwhile, we found that the length of DUP was positively correlated with the negative symptom score of the PANSS, negatively correlated with visual span scores, and GAF scores.ConclusionThis study demonstrated that the DUP remained a significant association with negative symptom and cognition in long period of chronic SCZ.

The Impact of Prolonged Duration of Untreated Illness on Clinical Correlates in Chronic Schizophrenia: Exploring the Relationship With Suicide Risk

“…Our main finding is that the longer the DUI, the worse the clinical characteristics of schizophrenic patients, including higher PANSS negative scale scores, lower immediate memory scores, and a higher likelihood of being overweight. These results align with previous research indicating that an extended duration of schizophrenia is correlated with more severe negative symptoms [ 46 ]. Negative symptoms encompass emotional apathy, blunted affect, and reduced volitional activity [ 4 , 59 , 60 ].…”

“…Our study highlights a significant proportion (23.3%) of Chinese patients with chronic schizophrenia who did not receive their initial treatment until 4 years after the onset of symptoms, consistent with previous studies. Undeniably, schizophrenia in China has a long, untreated duration [ 45 , 46 ]. The lack of timely treatment for schizophrenia patients is a complex problem in China [ 27 ].…”

“…Notably, a longer DUI was associated with lower suicide ideation and attempts. This finding appears counterintuitive, as one might expect that a longer period of untreated illness would lead to worse outcomes [ 46 ], especially suicide [ 27 , 29 ].…”

“…Undeniably, schizophrenia in China has a long, untreated duration. 45,46 The lack of timely treatment for schizophrenia patients is a complex problem in China. 27 Research from the National Institutes of Health-funded Michael Phillips found many untreated schizophrenia patients over 60 in China; 47 in rural China, untreated psychosis is even as high as 22.9 years.…”

“…These results align with previous research indicating that an extended duration of schizophrenia is correlated with more severe negative symptoms. 46 Negative symptoms encompass emotional apathy, blunted affect, and reduced volitional activity. 4,59,60 Contributing to profound social and occupational impairment, suicide risk, and mental disability.…”