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The British Journal of Psychiatry (2001) 179: 340-345
© 2001 The Royal College of Psychiatrists

Duration of untreated psychosis and cognitive functioning in first-episode patients

ROSS M. G. NORMAN, PhD

Prevention and Early Intervention Program, London, Ontario, Canada

LAUREL TOWNSEND, PhD

Prevention and Early Intervention Program, London, Ontario, Canada

ASHOK K. MALLA, FRCP(C)

Prevention and Early Intervention Program, London, Ontario and Department of Psychiatry, Faculty of Medicine, University of Western Ontario, London, Ontario

Correspondence: Dr Ross M. G. Norman, Room 113B, WMCH Building, 392 South Street, London, Ontario N6A 4G5, Canada. E-mail: rnorman{at}julian.uwo.ca

Declaration of interest None. Funding received from the Medical Research Council of Canada.

Background The ‘toxicity’ model of duration of untreated psychosis (DUP) suggests that longer DUP will be associated with poorer performance on cognitive tests in first-episode patients.

Aims To test this hypothesis on a sample of 113 patients in a community-based early intervention programme for psychosis.

Method Information was collected concerning a number of possible predictors of cognitive functioning including DUP. These were examined for their relation to performance on an extensive battery of cognitive tests administered shortly after the patients' admission to the programme.

Results Although several variables such as gender, premorbid adjustment, education and handedness predicted cognitive functioning, no relation was found between DUP and performance on any component of the test battery.

Conclusions Findings do not provide support for a toxic effect of DUP on cognitive functioning. Other mechanisms through which DUP might affect outcome such as psychological engulfment, social support and adherence to medication are discussed.


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