ABSTRACT

Research Theme

Association between duration of untreated psychosis (DUP) and remission in first-episode schizophrenia.

Abstract

Background: The duration of untreated psychosis (DUP) affects remission and relapse in schizophrenia. A number of studies have reported the relevance of DUP and remission including factors causing longer DUP in first-episode schizophrenia are limited.
Objective: To examine the potential association between DUP and remission, the rates of remission and predictive factors for remission and longer DUP.
Methods: A prospective study of 206 first-episode schizophrenic patients that was conducted in eight hospitals of Thailand. Remission was assessed according to the definition and criteria proposed by the Remission in Schizophrenia Working Group (RSWG). The patients were categorized into short DUP (<4 weeks) and long DUP (≥4 weeks ) groups using a median split.
Results: 67% of patients met the remission criteria at 6 months follow-up time. The short DUP group experienced a significantly higher remission rate. In the logistic regression analysis after adjustment for potential confounding, two strongest predictor of remission were shorter DUP and baseline PANSS scores. Income and history of alcohol use within 3 months were significantly predictive of longer DUP.
Conclusion: DUP appears to be a modest independent predictor of prognosis in remission.
Results support the need for assertive early detection strategies especially, reduce caused of longer DUP.