The British Journal of Psychiatry (2008) 193: 203-209. doi: 10.1192/bjp.bp.108.049718
© 2008 The Royal College of Psychiatrists
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Duration of untreated psychosis and social function: 1-year follow-up study of first-episode schizophrenia

Thomas R. E. Barnes, DSc, Verity C. Leeson, PhD and Stanley H. Mutsatsa, MSc

Division of Neuroscience and Mental Health, Imperial College London, Faculty of Medicine

Hilary C. Watt, MSc

Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London

Sam B. Hutton, DPhil

Department of Psychology, University of Sussex, Brighton

Eileen M. Joyce, FRCPsych

University College London, Institute of Neurology, London, UK

Correspondence: Professor Thomas R. E. Barnes, Department of Psychological Medicine, Division of Neuroscience and Mental Health, Imperial College Faculty of Medicine, St Dunstan’s Road, London W6 8RF, UK. Email: t.r.barnes{at}imperial.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

In first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes.

Aims

To address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point.

Method

Symptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later.

Results

There was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition.

Conclusions

Longer DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP.


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