Duration of untreated psychosis/illness and brain volume changes in early psychosis

Abstract

The time period during which patients manifest psychotic or unspecific symptoms prior to treatment (duration of untreated psychosis, DUP, and the duration of untreated illness, DUI) has been found to be moderately associated with poor clinical and social outcome. Equivocal evidence exists of an association between DUP/DUI and structural brain abnormalities, such as reduced hippocampus volume (HV), pituitary volume (PV) and grey matter volume (GMV). Thus, the goal of the present work was to examine if DUP and DUI are associated with abnormalities in HV, PV and GMV. Using a region of interest (ROI) based approach, we present data of 39 patients from the Basel FePsy (Früherkennung von Psychosen, early detection of psychosis) study for which information about DUP, DUI and HV, PV and GMV data could be obtained. Twenty-three of them were first episode psychosis (FEP) and 16 at-risk mental state (ARMS) patients who later made the transition to frank psychosis. In unadjusted analyses, we found a significant positive correlation between DUP and PV in FEP patients. However, when adjusted for covariates, we found no significant correlation between DUP or DUI and HV, PV or GMV anymore. There only was a trend for decreasing GMV with increasing DUI in FEP. Our results do not comprehensively support the hypothesis of a "toxic" effect of the pathogenic mechanism underlying untreated psychosis on brain structure. If there is any effect, it might rather occur very early in the disease process, during which patients experience only unspecific symptoms.

Erectile dysfunction in patients with first‐episode psychosis

“…We found a negative correlation between DUP and IIEF‐5 scores and a positive correlation between DUP and serum prolactin levels; these findings help explain the greater incidence of ED and hyperprolactinemia with increased duration of untreated psychosis (DUP). This point is consistent with a study by Rapp et al (2017) that found a significant positive correlation between DUP and pituitary volume.…”

Screening for psychosis risk among help‐seeking adolescents: Application of the Italian version of the 16‐item prodromal questionnaire (iPQ‐16) in child and adolescent neuropsychiatry services

“…Table shows demographic characteristics and screening outcomes of the entire sample and of the CAARMS [+] ( n = 44) and CAARMS [−] ( n = 28) sub‐samples. No significant differences were found between groups in terms of gender, ethnic group, mother tongue, age, years of education and “Duration of Untreated Illness” (DUI), that is, time (in weeks) from onset of a prominent psychiatric symptom and the administration of the first pharmacological/psychological treatment (Rapp et al, ).…”

Assessing aberrant salience in young community help‐seekers with early psychosis: The approved Italian version of the Aberrant Salience Inventory

“…Moreover, we explored the divergent validity by testing whether i‐ASI scores were less strongly correlated with anhedonia than SPQ‐B measures. In addition, we examined any relevant association of the i‐ASI total score with sociodemographic characteristics (i.e., gender, age, and years of education) and duration of untreated illness (DUI; defined as the time interval [in weeks] between the onset of a prominent psychiatric symptom and the administration of the first pharmacological/psychological treatment; Rapp et al, 2017) in the total sample, using Mann‐Whitney U test or Spearman's correlation coefficients, as appropriate.…”