Duration of untreated psychosis predicts functional and clinical outcome in children and adolescents with first-episode psychosis: A 2-year longitudinal study

Fraguas, David; Rey-Mejías, Ángel Del; Moreno, Carmen; Castro‐Fornieles, Josefina; Graell, Montserrat; Otero, Soraya; González‐Pinto, Ana; Moreno, Dolores; Baeza, Inmaculada; Martínez‐Cengotitabengoa, Mónica; Arango, Celso; Parellada, Mara

doi:10.1016/j.schres.2013.11.018

Cited by 61 publications

(38 citation statements)

References 52 publications

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“…Following this study, it is now important to understand factors associated with the outcome. In FES, frequently reported predictors of remission (severity and duration criteria) for maintenance treatment include shorter duration of untreated psychosis (DUP), lower negative symptoms at baseline, enhanced premorbid functioning and early response (AlAqeel & Margolese, 2012;Díaz et al, 2013;Fraguas et al, 2014;Gaebel et al, 2014;Simonsen et al, 2010;Veru, Jordan, Joober, Malla, & Iyer, 2016). Moreover, length of symptomatic remission is a strong predictor of social and occupational functioning in FES, which highlights the importance of promptly achieving and maintaining symptomatic remission (Jordan et al, 2014).…”

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confidence: 99%

Predictors of remission during acute treatment of first‐episode schizophrenia patients involuntarily hospitalized and treated with algorithm‐based pharmacotherapy: Secondary analysis of an observational study

Yoshimura

Sakamoto

Sato

et al. 2017

Early Intervention Psych

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confidence: 99%

Predictors of remission during acute treatment of first‐episode schizophrenia patients involuntarily hospitalized and treated with algorithm‐based pharmacotherapy: Secondary analysis of an observational study

Yoshimura

Sakamoto

Sato

et al. 2017

Early Intervention Psych

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“…A long DUP has been found to be associated with more severe positive and negative symptoms [10][11][12], longer length of first hospitalization [13], poorer remission status and higher risk of relapse and rehospitalisation [8,11,13,14]. Such negative outcomes can lead to further consequences, such as increased burden and expressed emotion in the family [15], reduced compliance to treatment [16,17], lower treatment response rates [18][19][20][21][22], increased risk of depression, suicide and self-harming behaviour [23][24][25], higher risk of violence, aggression and delinquent behaviour [26][27][28] and eventually greater impairment in general functioning, social functioning and quality of life [11,14,29,30].…”

Section: Clinical Relevance and Impact Of Delayed Treatmentmentioning

confidence: 99%

The Psychosis High-Risk State

Rutigliano¹,

Manalo²,

Fusar‐Poli

2016

Key Issues in Mental Health

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The disabling nature and costly impact of mental disorders, such as schizophrenia, can cause significant burden to both person and society. It is also indicated that the negative outcomes associated with psychosis may, in part, be due to the delayed detection and initiation of treatment. Preventative interventions in several arenas of medicine have advanced; however have only come to the fore in psychiatry in the last two decades. It was long-known that a preclinical phase preceded psychosis, now commonly termed as ultra high-risk (UHR) status.The advent of specialized early intervention services provided the cornerstone in taking a preventative and timely endeavor to maximize the chance of positive outcomes in psychosis.Despite the potential, the current state of the UHR concept lacks consensus in how at-risk individuals should be approached. This chapter aims to provide an overview of how preventative medicine can intersect with psychiatry by focusing on the psychosis high risk state. It describes the current criteria and screening procedures used to prospectively detect UHR individuals, as well as discussing the validity of these tools. Whilst advocating the benefits of focused interventions, this chapter also recognizes current challenges and the controversy that leaves the psychosis high risk state on fertile ground for wavering opinions.The chapter concludes with an exploration and discussion that proposes an improved conceptualization of the high risk state and how this can direct intervention, as well as suggesting future lines of research in this area.2

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“…Longer DUP is associated with poorer long-term symptomatic and functional outcomes in first episode psychosis (Boonstra et al, 2012;Hill et al, 2012;Marshall et al, 2005;Perkins, 2006). In adolescent psychosis, long DUP has been associated with subsequent global functioning and executive functioning difficulties (Fraguas, del Rey-Mejias, et al, 2014) and lower pre-morbid social functioning has been associated with more severe negative symptoms and poorer social functioning at 12 months (Meng et al, 2006). Recent studies have found that DUP is related to individual and service factors such as age, cannabis-use, delayed help-seeking and referral route (Bechard-Evans et al, 2007;Cratsley, Regan, McAllister, Simic, & Aitchison, 2008;Dominguez et al, 2013;Fond et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes and associations in an adolescent‐specific early intervention for psychosis service

Thomson

Griffiths

Fisher

et al. 2019

Early Intervention Psych

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Aim: Compared with adult onset psychosis, adolescent psychosis has been associated with poorer outcomes in terms of social and cognitive functioning and negative symptoms. Young people experiencing first episode psychosis have developmental needs that frequently pre-date and are compounded by psychosis onset (a previous study). There is a lack of published studies of adolescent onset psychosis and further information is needed so that developmentally appropriate interventions can be developed. We report an observational naturalistic cohort study of an adolescent specific service, the Early Psychosis Support service (EPSS).Method: We examined baseline demographic and clinical variables, treatments outcomes and predictors of outcome for this population.Results: The mean age of our sample was 16.3 years. Median duration of untreated illness (DUI) was 88 weeks, and median duration of untreated psychosis (DUP) was 16 weeks. We found significant improvements in positive symptoms, negative symptoms, disorganization, excitement, emotional distress and depression from 0 to 12 months. We found that baseline positive symptoms and DUI significantly predicted positive symptoms at 12 months and only negative symptoms at baseline predicted 12-month negative symptoms.Conclusion: Our finding that specialist early intervention for adolescents experiencing psychosis is effective suggests that such treatment should be routinely offered in line with existing clinical guidelines. Our finding that DUI is predictive of poorer outcome at 12 months suggests that even earlier intervention from a specialist team may further improve treatment outcomes.

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Duration of untreated psychosis predicts functional and clinical outcome in children and adolescents with first-episode psychosis: A 2-year longitudinal study

Cited by 61 publications

References 52 publications

Predictors of remission during acute treatment of first‐episode schizophrenia patients involuntarily hospitalized and treated with algorithm‐based pharmacotherapy: Secondary analysis of an observational study

Predictors of remission during acute treatment of first‐episode schizophrenia patients involuntarily hospitalized and treated with algorithm‐based pharmacotherapy: Secondary analysis of an observational study

The Psychosis High-Risk State

Treatment outcomes and associations in an adolescent‐specific early intervention for psychosis service

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