The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis

Jeppesen, Pia; Petersen, L.; Thorup, Anne; Abel, M.; Øhlenschlæger, Johan; Christensen, Thomas; Krarup, Gertrud; Jørgensen, Per; Nordentoft, Merete

doi:10.1017/s0033291708003449

Cited by 101 publications

(76 citation statements)

References 30 publications

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“…Longer DUP is associated with a poorer outcome of psychosis at 2 years. 23 A meta-analysis of nine adolescent and adult studies found no association between cannabis use and DUP; however the author noted an association between the timing of cannabis use and DUP. While DUP was shorter in cannabis users in studies where cannabis use was defined in terms of current or recent use; DUP was longer in cannabis users in studies based on lifetime cannabis use.…”

Section: Cannabis and Duration Of Untreated Psychotic Symptomsmentioning

confidence: 99%

Cannabis and mental illness in adolescents: a review

Paruk

Burns

2015

South African Family Practice

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Section: Cannabis and Duration Of Untreated Psychotic Symptomsmentioning

confidence: 99%

Cannabis and mental illness in adolescents: a review

Paruk

Burns

2015

South African Family Practice

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“…With respect to schizophrenia, these include the notions that (1) the disorder generally starts in late adolescence/early adulthood, (2) it often remains untreated for months and years before being recognized and adequately treated, and (3) it frequently shows a chronic course, with several relapses or a continuous and progressive deterioration at different levels [13,14]. All these features dramatically impact on the social, family and vocational life of patients and their families.…”

Section: Resultsmentioning

confidence: 99%

“…schizophrenia and bipolar disorder). Many people with FEP do not seek help for themselves [19]: for instance, large sample studies in schizophrenia have found mean DUP values ranging from 8 to 48 weeks in first-episode patients [13,14]. In bipolar disorder, mean DUI values tend to be even longer ranging, from 5 to 10 years [9,20].…”

Section: Resultsmentioning

confidence: 99%

Can Long-Term Outcomes Be Improved by Shortening the Duration of Untreated Illness in Psychiatric Disorders? A Conceptual Framework

et al. 2012

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The duration of untreated illness (DUI), meaning the latency to the pharmacological treatment, has been increasingly investigated in the last decade as a predictor of outcome across different psychiatric conditions, particularly in psychotic disorders. DUI is essentially computed by subtracting the age of onset of a specific disorder from the age at which the first adequate pharmacological treatment is administered. Assessment of the latency to treatment represents one of the first steps in planning early interventions. This review examines the role of the DUI in psychotic and affective disorders, focusing on neuropathological, epidemiologic, clinical and prognostic factors related to a longer latency to treatment. Through a Medline and Cochrane Library search, relevant studies up to June 2011 and other pertinent articles including meta-analyses, randomized controlled trials, naturalistic studies and clinical reviews were identified. Converging evidence indicates that a prolonged DUI negatively influences the outcome of first-episode psychosis and schizophrenia in different ways, and increasing data point toward a similar conclusion in affective disorders. Even though methodological limitations related to investigation of the DUI need to be considered, research and interventions aimed to reduce latency to treatments are object of increasing implementation worldwide. The assessment of the DUI represents one of the most important parameters to consider in this perspective, in order to quantify different latency to treatment in specific disorders and to plan related, targeted interventions.

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“…Patients with predominantly negative symptoms have poor pre-morbid adjustment during childhood or early adolescence and a low employment rate during adulthood, achieve low educational attainment and exhibit considerable cognitive impairment (Milev et al 2005;Rosenheck et al 2006;Jeppesen et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Prefrontal cortical thinning links to negative symptoms in schizophrenia via the ENIGMA consortium

et al. 2017

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Background. Our understanding of the complex relationship between schizophrenia symptomatology and etiological factors can be improved by studying brain-based correlates of schizophrenia. Research showed that impairments in value processing and executive functioning, which have been associated with prefrontal brain areas [particularly the medial orbitofrontal cortex (MOFC)], are linked to negative symptoms. Here we tested the hypothesis that MOFC thickness is associated with negative symptom severity. Results. Meta-analytical results showed that left, but not right, MOFC thickness was significantly associated with negative symptom severity (β std = −0.075; p = 0.019) after accounting for age, gender, and site. This effect remained significant (p = 0.036) in a model including overall illness severity. Covarying for duration of illness, age of onset, antipsychotic medication or handedness weakened the association of negative symptoms with left MOFC thickness. As part of a secondary analysis including 10 other prefrontal regions further associations in the left lateral orbitofrontal gyrus and pars opercularis emerged.Conclusions. Using an unusually large cohort and a meta-analytical approach, our findings point towards a link between prefrontal thinning and negative symptom severity in schizophrenia. This finding provides further insight into the relationship between structural brain abnormalities and negative symptoms in schizophrenia.

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The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis

Cited by 101 publications

References 30 publications

Cannabis and mental illness in adolescents: a review

Cannabis and mental illness in adolescents: a review

Can Long-Term Outcomes Be Improved by Shortening the Duration of Untreated Illness in Psychiatric Disorders? A Conceptual Framework

Prefrontal cortical thinning links to negative symptoms in schizophrenia via the ENIGMA consortium

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