Exploration of symptom dimensions and duration of untreated psychosis within a staging model of schizophrenia spectrum disorders

Abstract

Aim: Clinical staging of schizophrenia entails a new method that identifies clusters of symptoms and variation in level of remission, with the goal to create a framework for early intervention. Additionally, duration of untreated psychosis (DUP) may influence symptom severity in the first episode of psychosis (FEP) and could necessitate refining of the staging model. However, consistent evidence concerning variation in symptom severity and DUP between stages is missing. Therefore, we evaluated the clinical validity of the staging model by investigating differences in symptom severity across stages in schizophrenia spectrum disorders. Second, we assessed if a prolonged DUP is associated with higher symptom severity in FEP. Methods: We performed a cross-sectional study of 291 acutely admitted patients with a schizophrenia spectrum disorder. Patients were assigned to clinical stages following the definition of McGorry. Symptom severity was evaluated with the new DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS). In FEP, we determined the DUP. Results: Significantly higher severity scores of CRDPSS items hallucinations

Is it possible to stage schizophrenia? A systematic review

“…The results showed that, one year later, the majority of the patients were in the same stage and greater improvements occurred in more severe stages (Table 2 ). Recently, Berendsen et al [ 24 ] developed a study whose results support the clinical validation of this staging model. Patients showed significant differences in the severity of negative, positive, and cognitive symptoms between stages.…”

Association of cognitive performance with clinical staging in schizophrenia spectrum disorders: a prospective 6-year follow-up study

“…So far only few studies investigated the associations between cognitive functioning and stages ( Berendsen et al, 2021 ; Godin et al, 2019 ; Tedja et al, 2017 ). Two studies also showed associations of cognitive deficits with higher stages of illness.…”

“…In addition, the authors found that baseline cognitive parameters did not predict stage-transition at three-year follow-up( Tedja et al, 2017 ). Lastly, another cross-sectional study found significantly more decline in global cognitive functioning at more advanced disease stages in acutely admitted inpatients with schizophrenia spectrum disorders ( Berendsen et al, 2021 ). The majority of the latter studies were cross-sectional or had a short-term follow-up, which is less suitable to evaluate stage-transition in relation to cognitive performance.…”

Psychosis in Women: Time for Personalized Treatment

“…The transition to psychosis has been shown to occur according to a staging model much like the staging of the development of other medical disorders such as cancer and hypertension [42][43][44]. The staging has been proposed to be characterized by gender-specific factors [45,46].…”