What are the physical and mental health implications of duration of untreated psychosis?

Pablo, Gonzalo Salazar de; Guinart, Daniel; Correll, Christoph U.

doi:10.1192/j.eurpsy.2021.22

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…In fact, it has been repeatedly confirmed that the long-term trajectory of any mental disorder is highly influenced by treatments provided to patients in the first years of the disease [54][55][56]. Therefore, the early detection and appropriate treatment of any mental disorder is essential to improve the long-term prognosis of patients [57][58][59][60][61][62]. This model must also be applied to other severe mental disorders, including obsessive-compulsive disorder, which has been overlooked and wrongly considered "less" severe compared to psychosis.…”

Section: Discussionmentioning

confidence: 99%

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Perris,

Cipolla,

Catapano

et al. 2023

JPM

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Background: Duration of untreated illness (DUI)—defined as the time period between the onset of a mental disorder and its first adequate treatment—should influence patients’ long-term prognosis and outcome. In patients with obsessive–compulsive disorder (OCD), DUI lasts on average from 87.5 up to 94.5 months, being significantly longer compared with data available from patients affected by other severe mental disorders, such as schizophrenia and bipolar disorder. We carried out a systematic review in order to assess the impact of DUI on long-term outcomes in OCD patients. Methods: A systemic review has been implemented, searching from inception to April 2023; only papers written in English were included. Results: Seventy-one articles were initially identified; only eight papers were included in the review. The DUI ranged from 7.0 ± 8.5 to 20.9 ± 11.2 years. Patients reporting a longer DUI have a poor long-term outcome in terms of lower level of treatment response and greater symptom severity. Conclusions: The present review confirms that longer DUI has a negative impact on the long-term outcome of patients with OCD. It should be useful to promote the dissemination of early interventions with a specific focus on OCD symptoms.

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Section: Discussionmentioning

confidence: 99%

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Perris,

Cipolla,

Catapano

et al. 2023

JPM

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“…Interventions to reduce DUP based on early detection and early intervention in FEP have been developed 4 , 21 based on the hypothesis that prolonged DUP leads to significant neurological and psychosocial damage that worsens the illness course of psychotic disorders. 22 Early Intervention services (EIS) have been implemented to reduce DUP with promising results. In EIS, multidisciplinary teams of mental health professionals provide multimodal treatment, including different psychosocial and psychopharmacological interventions that are tailored to the needs of each patient.…”

Section: Introductionmentioning

confidence: 99%

Duration of Untreated Psychosis and Outcomes in First-Episode Psychosis: Systematic Review and Meta-analysis of Early Detection and Intervention Strategies

Salazar de Pablo,

Guinart,

Armendariz

et al. 2024

Schizophrenia Bulletin

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Background The role of duration of untreated psychosis (DUP) as an early detection and intervention target to improve outcomes for individuals with first-episode psychosis is unknown. Study Design PRISMA/MOOSE-compliant systematic review to identify studies until February 1, 2023, with an intervention and a control group, reporting DUP in both groups. Random effects meta-analysis to evaluate (1) differences in DUP in early detection/intervention services vs the control group, (2) the efficacy of early detection strategies regarding eight real-world outcomes at baseline (service entry), and (3) the efficacy of early intervention strategies on ten real-world outcomes at follow-up. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD42020163640). Study Results From 6229 citations, 33 intervention studies were retrieved. The intervention group achieved a small DUP reduction (Hedges’ g = 0.168, 95% CI = 0.055–0.283) vs the control group. The early detection group had better functioning levels (g = 0.281, 95% CI = 0.073–0.488) at baseline. Both groups did not differ regarding total psychopathology, admission rates, quality of life, positive/negative/depressive symptoms, and employment rates (P > .05). Early interventions improved quality of life (g = 0.600, 95% CI = 0.408–0.791), employment rates (g = 0.427, 95% CI = 0.135–0.718), negative symptoms (g = 0.417, 95% CI = 0.153–0.682), relapse rates (g = 0.364, 95% CI = 0.117–0.612), admissions rates (g = 0.335, 95% CI = 0.198–0.468), total psychopathology (g = 0.298, 95% CI = 0.014–0.582), depressive symptoms (g = 0.268, 95% CI = 0.008–0.528), and functioning (g = 0.180, 95% CI = 0.065–0.295) at follow-up but not positive symptoms or remission (P > .05). Conclusions Comparing interventions targeting DUP and control groups, the impact of early detection strategies on DUP and other correlates is limited. However, the impact of early intervention was significant regarding relevant outcomes, underscoring the importance of supporting early intervention services worldwide.

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Umbrella Review: Atlas of the Meta-Analytical Evidence of Early-Onset Psychosis

Salazar de Pablo,

Rodriguez,

Besana

et al. 2024

Journal of the American Academy of Child & Adolescent Psych

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What are the physical and mental health implications of duration of untreated psychosis?

Cited by 3 publications

References 11 publications

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Duration of Untreated Psychosis and Outcomes in First-Episode Psychosis: Systematic Review and Meta-analysis of Early Detection and Intervention Strategies

Umbrella Review: Atlas of the Meta-Analytical Evidence of Early-Onset Psychosis

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