Bottlender Ronald, Sato Tesuya, Jäger Markus, Wegener Ulrike, Wittmann Johannes, Strauss Anton, Möller Hans-Jürgen
Department of Psychiatry, Ludwig Maximilians University, Nussbaumstrasse 7, 80336 Munich, Germany.
Schizophr Res. 2003 Jul 1;62(1-2):37-44. doi: 10.1016/s0920-9964(02)00348-1.
There is a large amount of evidence to support the hypothesis that the duration of untreated psychosis (DUP) prior to first psychiatric admission adversely affects acute treatment response and short-term outcome in schizophrenia. However, only few prospective studies have attempted to address a possible association between DUP and long-term outcome.
Fifty-eight DSM-III-R schizophrenic patients were assessed at their first psychiatric admission and after a 15-year course of the illness. The 15-year outcome in different domains was compared between patients with different DUPs prior to the first psychiatric admission.
A longer DUP was associated with more pronounced negative, positive and general psychopathological symptoms as well as a lower global functioning 15 years after the first psychiatric admission, even after effects of other factors, possibly related to the long-term outcome, were controlled for.
The DUP prior to first psychiatric admission adversely affects the long-term outcome in schizophrenia. The findings underline the importance of establishing health service programs for early detection and treatment of schizophrenic patients with the aim to shorten the DUP and to consequently improve the course and outcome of schizophrenic patients.
有大量证据支持这样的假说，即首次精神科入院前未治疗精神病的持续时间（DUP）会对精神分裂症的急性治疗反应和短期预后产生不利影响。然而，仅有少数前瞻性研究试图探讨DUP与长期预后之间可能存在的关联。
对58例DSM-III-R精神分裂症患者在首次精神科入院时及病程15年后进行评估。比较首次精神科入院前具有不同DUP的患者在不同领域的15年预后情况。
即使在控制了其他可能与长期预后相关因素的影响后，首次精神科入院前较长的DUP仍与首次入院15年后更明显的阴性、阳性及一般精神病理症状以及更低的整体功能相关。
首次精神科入院前的DUP会对精神分裂症的长期预后产生不利影响。这些发现强调了建立卫生服务项目以早期发现和治疗精神分裂症患者的重要性，目的是缩短DUP，从而改善精神分裂症患者的病程和预后。
