Duration of untreated psychosis and cognitive functioning in first-episode patients

Abstract

Findings do not provide support for a toxic effect of DUP on cognitive functioning. Other mechanisms through which DUP might affect outcome such as psychological engulfment, social support and adherence to medication are discussed.

Untreated Initial Psychosis: Relation to Cognitive Deficits and Brain Morphology in First-Episode Schizophrenia

“…If such pathogenic processes are also present around the onset of clinical symptoms, it appears that untreated psychosis is not a contributing factor. On the basis of our findings as well as those of other investigators (19,20,22,36), the pattern of mostly small correlation coefficients and the paucity of significant differences between patients with long and short duration of untreated initial psychosis do not support the frequently expressed belief that long periods of untreated psychosis have a pronounced impact on neurocognitive functioning or on brain morphology in schizophrenia.…”

“…None of the correlations was significant, and all were within 95% confidence intervals. In another study of 120 first-episode patients, from the Prevention and Early Intervention Program for Psychosis in London, Ontario, Norman et al (36) reported that duration of untreated initial psychosis was not related to performance on an extensive battery of cognitive measures. Structural brain abnormalities and cognitive deficits in schizophrenia are evident by the time patients first come in for treatment (see reviews in references 37,38).…”

Attitudes Toward Help-Seeking and Duration of Untreated Mental Disorders in a Sectorized Athens Area of Greece

“…In this study, severity of diagnosis was synonymous with schizophrenia and related diagnoses. This finding is not compatible with the existing literature that refers to the lack of insight, the fear of inpatient treatment and the social isolation as common barriers of a person suffering from psychosis to visit a specialist (McGorry et al 1996;Norman et al 2001;Addington et al 2002). In our case, the majority of individuals of group A carrying a diagnosis of schizophrenia had visited the Emergency Units of three neighbouring General Hospitals which functioned as liaison services.…”

The Self-screen-Prodrome as a short screening tool for pre-psychotic states

“…With an onset mostly in adolescence and young adulthood, relevant developments and achievement of social roles often are impaired. Delayed diagnosis and treatment is associated with a worse long-term prognosis, which might be minimized by early detection and intervention (Riecher-Rössler et al, 2006;Harrigan et al, 2003;Larsen et al, 2001;McGorry, 2002;Norman et al, 2001;Pelosi et al, 2003). However, especially in low incidence disorders such as schizophrenia, early diagnosis with clinical examinations such as a structured face-to-face interview of the general population would be much too extensive.…”