Barnes Thomas R E, Leeson Verity C, Mutsatsa Stanley H, Watt Hilary C, Hutton Sam B, Joyce Eileen M
Department of Psychological Medicine, Imperial College Faculty of Medicine, St Dunstan's Road, London W6 8RF, UK.
Br J Psychiatry. 2008 Sep;193(3):203-9. doi: 10.1192/bjp.bp.108.049718.
In first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes.
To address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point.
Symptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later.
There was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition.
Longer DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP.
在首发精神分裂症中，未治疗精神病持续时间（DUP）越长，预后越差。
探讨DUP与预后之间的关系是直接因果关系，还是症状和/或认知功能与社会功能在同一时间点的关联结果。
对98例首发精神分裂症患者在就诊时及1年后进行症状、社会功能和认知功能评估。
就诊时DUP短和长的参与者之间无显著临床差异。线性回归分析显示，较长的DUP显著预测1年后更严重的阳性和阴性症状以及更差的社会功能，与就诊时的得分无关。路径分析显示DUP与社会功能、核心阴性症状和阳性症状之间存在独立的直接关系。DUP与认知之间无显著关联。
较长的DUP独立于症状预测较差的社会功能。研究结果强调了在研究DUP的影响时，考虑阴性症状测量与社会功能之间现象学重叠的重要性。
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