Norman Ross M G, Lewis Shôn W, Marshall Max
Department of Psychiatry, University of Western Ontario, Room 113B, WMCH Building, 392 South Street, London, Ontario N6A 4G5, Canada.
Br J Psychiatry Suppl. 2005 Aug;48:s19-23. doi: 10.1192/bjp.187.48.s19.
A major reason for interest in early intervention for psychotic disorders is the hypothesised relationship between longer duration of untreated psychosis (DUP) and poorer outcome of treatment.
To critically examine the evidence concerning DUP being related to treatment outcome and possible mediators of any such relationship.
A systematic review of studies in which DUP is assessed and its relationship to treatment outcome is examined. In addition, studies relevant to possible neurotoxic effects of DUP were reviewed.
The research is entirely of a correlational nature and, therefore, firm conclusions regarding causation are not possible. There is, however, substantial evidence of DUP being an independent predictor of treatment outcome, particularly remission of positive symptoms, over the first year or so of treatment. Findings regarding the possible neurotoxic effects of DUP are inconsistent.
There continues to be evidence consistent with DUP influencing aspects of treatment outcome. Non-correlational studies, such as quasi-experimental designs, could provide stronger evidence regarding causality.
对精神障碍进行早期干预的一个主要原因是，人们假设未治疗精神病持续时间（DUP）较长与治疗效果较差之间存在关联。
批判性地审视有关DUP与治疗效果相关的证据，以及这种关系可能的中介因素。
对评估DUP并考察其与治疗效果关系的研究进行系统综述。此外，还综述了与DUP可能的神经毒性作用相关的研究。
该研究完全是相关性的，因此，关于因果关系无法得出确凿结论。然而，有大量证据表明，在治疗的第一年左右，DUP是治疗效果的独立预测因素，尤其是阳性症状的缓解。关于DUP可能的神经毒性作用的研究结果并不一致。
仍有证据表明DUP会影响治疗效果的某些方面。非相关性研究，如准实验设计，可能会提供更强的因果关系证据。
