Addington J, Van Mastrigt S, Addington D
Department of Psychiatry, University of Calgary, Alberta, Canada.
Psychol Med. 2004 Feb;34(2):277-84. doi: 10.1017/s0033291703001156.
The duration of untreated psychosis has been postulated to be a predictor of clinical outcome in schizophrenia. Although several prospective studies support the relationship, some studies do not. These differences may be due to a number of methodological issues. The objectives of this study are: (i) to address many of the methodological limitations of earlier studies such as variations in sample size and selection, type of treatment provided, differences in measurement of DUP and outcome, and length of follow-up; and (ii) to examine the relationship between DUP and outcome in a prospective longitudinal study.
The DUP of 200 consecutive admissions to a first-episode programme was determined. The sample was followed over 2 years and pre-morbid functioning, symptoms, social and cognitive functioning and substance use were assessed longitudinally.
Two years after admission to the programme, longer DUP was significantly associated with high levels of positive symptoms and poor social functioning. Independently of other variables, DUP predicted positive symptoms and social functioning at 1 and 2 years.
There is evidence that long DUP continues to have an influence on outcome up to 2 years. These results support ongoing efforts for early detection and intervention.
未经治疗的精神病持续时间被认为是精神分裂症临床结局的一个预测指标。尽管一些前瞻性研究支持这种关系，但也有一些研究并不支持。这些差异可能归因于一些方法学问题。本研究的目的是：（i）解决早期研究中的许多方法学局限性，如样本大小和选择的差异、所提供治疗的类型、未治疗精神病持续时间（DUP）和结局测量的差异以及随访时间长度；（ii）在一项前瞻性纵向研究中检验DUP与结局之间的关系。
确定了连续200例首次发作项目入院患者的DUP。对样本进行了2年的随访，并纵向评估了病前功能、症状、社会和认知功能以及物质使用情况。
入院2年后，较长的DUP与高水平的阳性症状和较差的社会功能显著相关。独立于其他变量，DUP在1年和2年时预测了阳性症状和社会功能。
有证据表明，较长的DUP在长达2年的时间里持续对结局产生影响。这些结果支持了持续进行的早期发现和干预的努力。
