Michael L Birnbaum1,2,3,4, Claire Ramsay Wan5, Beth Broussard2, Michael T Compton2,3. 1. North Shore-LIJ Health System, Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, New York, USA. 2. North Shore-LIJ Health System, Department of Psychiatry, Lenox Hill Hospital, New York, New York, USA. 3. Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA. 4. The Feinstein Institute for Medical Research, Manhasset, New York, USA. 5. Physician Assistant Program, Tufts University School of Medicine, Boston, Massachusetts, USA.
Abstract
AIM: The duration of untreated psychosis (DUP) has been established as an independent and significant predictor of negative outcomes in first-episode psychosis samples. Whereas literature has supported the association between DUP and severity of positive and negative symptoms, surprisingly little research to date has explored specifically what types of positive and negative symptoms are most associated with DUP. METHODS: DUP, Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) data were collected in 247 first-episode psychosis participants (mean age: 23.9 ± 4.8) between August 2008 and June 2013. RESULTS: DUP was significantly but modestly associated with the severity of hallucinations (ρ = 0.222; P = 0.001), delusions (r = 0.202; P = 0.003) and formal thought disorder (ρ = 0.138; P = 0.043) but was not associated with bizarre behaviour. DUP was significantly but modestly associated with SANS avolition-apathy (ρ = 0.164; P = 0.016) and anhedonia-asociality (r = 0.321; P < 0.001) subscales but was not associated with affective flattening or blunting, alogia or attention. CONCLUSIONS: DUP is a complex and multifaceted phenomenon that is associated with early-course illness development. In efforts to improve early intervention services, prognoses and outcomes, it is vital to understand both the factors that contribute to lengthy untreated psychosis as well as the illness characteristics that are impacted by untreated psychosis.
AIM: The duration of untreated psychosis (DUP) has been established as an independent and significant predictor of negative outcomes in first-episode psychosis samples. Whereas literature has supported the association between DUP and severity of positive and negative symptoms, surprisingly little research to date has explored specifically what types of positive and negative symptoms are most associated with DUP. METHODS:DUP, Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) data were collected in 247 first-episode psychosisparticipants (mean age: 23.9 ± 4.8) between August 2008 and June 2013. RESULTS:DUP was significantly but modestly associated with the severity of hallucinations (ρ = 0.222; P = 0.001), delusions (r = 0.202; P = 0.003) and formal thought disorder (ρ = 0.138; P = 0.043) but was not associated with bizarre behaviour. DUP was significantly but modestly associated with SANS avolition-apathy (ρ = 0.164; P = 0.016) and anhedonia-asociality (r = 0.321; P < 0.001) subscales but was not associated with affective flattening or blunting, alogia or attention. CONCLUSIONS:DUP is a complex and multifaceted phenomenon that is associated with early-course illness development. In efforts to improve early intervention services, prognoses and outcomes, it is vital to understand both the factors that contribute to lengthy untreated psychosis as well as the illness characteristics that are impacted by untreated psychosis.
Keywords:
Scale for the Assessment of Negative Symptoms (SANS); Scale for the Assessment of Positive Symptoms (SAPS); duration of untreated psychosis (DUP); early intervention
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