Morgan Craig, Abdul-Al Rudwan, Lappin Julia M, Jones Peter, Fearon Paul, Leese Morven, Croudace Tim, Morgan Kevin, Dazzan Paola, Craig Tom, Leff Julian, Murray Robin
Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Br J Psychiatry. 2006 Nov;189:446-52. doi: 10.1192/bjp.bp.106.021303.
Despite considerable research investigating the relationship between a long duration of untreated psychosis (DUP) and outcomes, there has been much less considering predictors of a long DUP.
To investigate the clinical and social determinants of DUP in a large sample of patients with a first episode of psychosis.
All patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined catchment areas in London and Nottingham, UK were included in the AESOP study. Data relating to clinical and social variables and to DUP were collected from patients, relatives and case notes.
An insidious mode of onset was associated with a substantially longer DUP compared with an acute onset, independent of other factors. Unemployment had a similar, if less strong, effect. Conversely, family involvement in help-seeking was independently associated with a shorter duration. There was weak evidence that durations were longer in London than in Nottingham.
These findings suggest that DUP is influenced both by aspects of the early clinical course and by the social context.
尽管已有大量研究探讨未治疗精神病持续时间（DUP）与治疗结果之间的关系，但对于长DUP的预测因素的研究却少得多。
在大量首发精神病患者样本中调查DUP的临床和社会决定因素。
AESOP研究纳入了在两年期间与精神科服务机构接触、居住在英国伦敦和诺丁汉特定集水区的所有首发精神病患者。从患者、亲属和病历中收集了与临床和社会变量以及DUP相关的数据。
与急性起病相比，隐匿起病模式与长得多的DUP相关，且独立于其他因素。失业有类似但较弱的影响。相反，家庭参与寻求帮助与较短的病程独立相关。有微弱证据表明伦敦的病程比诺丁汉更长。
这些发现表明，DUP受早期临床病程和社会背景两方面因素影响。
