The British Journal of Psychiatry (2006) 189: 235-240. doi: 10.1192/bjp.bp.105.014068
© 2006 The Royal College of Psychiatrists
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Untreated illness and outcome of psychosis*

Mary Clarke, MD, MRCPI, MRCPsych, Peter Whitty, MD, MRCPsych, Stephen Browne, MD, MRCPsych, Orfhlaith McTigue, MRCPsych, Moayyad Kamali, MRCPsych and Maurice Gervin, MRCPsych

Department of Psychiatry, University College Dublin, and Stanley Research Unit, Cluain Mhuire Family Centre, St John of God Adult Psychiatric Service, Dublin

Anthony Kinsella, FIS

Department of Mathematics, Dublin Institute of Technology

John L. Waddington, DSc

Stanley Research Unit, Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin

Conal Larkin, FRCPI, FRCPsych and Eadbhard O'Callaghan, MD, FRCPI, FRCPsych

Department of Psychiatry, University College, Dublin, and Stanley Research Unit, Cluain Mhuire Family Centre, St John of God Adult Psychiatric Service, Dublin, Ireland

Correspondence: Professor Eadbhard O'Callaghan, DELTA/DETECT Early Intervention in Psychosis Services, 1 Marine Tec., Dun Laoghaire, Co. Dublin, Ireland. Tel: +353 12172100; fax: +353 1 2833886; email: eadbhard{at}gmail.com

Declaration of interest None.

Funded by the Stanley Medical Research Institute.

* Poster presentation at the 13th Biennial Winter Workshop on Schizophrenia, Davos, Switzerland, February 2004.

Background There has been controversy as to whether early intervention in psychosis can improve the outcome of the disorder.

Aims To establish if there is an association between duration of untreated psychosis and the 4-year outcome of persons with a first episode of psychosis.

Method Prospective naturalistic follow-up study of the outcome of consecutive first presentations with DSM-IV psychosis attending a community-based psychiatric service.

Results A longer duration of untreated psychosis was associated with a significantly poorer functional and symptomatic outcome 4 years later. For schizophrenia and schizophreniform disorder, each increment in duration of untreated psychosis was associated with a 7.8 point decrease in global functioning and an increase in positive symptoms scores by 1.9 points.

Conclusions This study extends the findings of short-term follow-up studies by confirming an association between duration of untreated psychosis and `mid-term' outcome.


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