Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis

Matti Penttilä , Erika Jääskeläinen , Noora Hirvonen , Matti Isohanni , Jouko Miettunen
  • Declaration of interest

    None.

Abstract

Background

Duration of untreated psychosis (DUP) is one of the few potentially modifiable predictors of outcomes of schizophrenia. Long DUP as a predictor of poor short-term outcome has been addressed in previous meta-analyses, but the long-term effects of DUP remain unclear.

Aims

To analyse the associations between DUP and long-term outcomes of schizophrenia.

Method

A systematic literature search was performed using seven electronic databases and manual searches. Random effects weighted meta-analysis with correlation coefficients was used to pool the results.

Results

We identified 3493 unique publications, from which 33 samples met our predefined selection criteria. Long DUP correlated statistically significantly with poor general symptomatic outcome, more severe positive and negative symptoms, lesser likelihood of remission and poor social functioning and global outcome (correlations 0.13-0.18). Long DUP was not associated with employment, quality of life or hospital treatment.

Conclusions

The small but mostly consistent correlation between long DUP and poor outcome indicates that early intervention in psychosis may have at least subtle positive effects on the long-term course of illness.

Footnotes

  • Funding

    This work was supported by Oulu University Hospital, University of Oulu, the Academy of Finland; the Sigrid Jusélius Foundation; National Alliance for Research in Schizophrenia and Affective Disorders (NARSAD): The Brain and Behavior Research Fund (Dr Mortimer D. Sackler Developmental Psychobiology Research Program); the Oulu University Pharmacy Foundation; H. Lundbeck; the Northern Finland Health Care Support Foundation; and the Jalmari and Rauha Ahokas Foundation.

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