Department of Neuropsychiatry, Kochi Medical School, Nankoku, Japan.
Early Interv Psychiatry. 2012 Aug;6(3):239-46. doi: 10.1111/j.1751-7893.2011.00325.x. Epub 2012 Jan 6.
We examined the duration of untreated psychosis (DUP) and its social and clinical correlates in patients with schizophrenia in a rural/suburban region of Japan.
We conducted a retrospective cohort study of patients with first-episode psychosis from 11 hospitals in Kochi Prefecture. There were 108 patients who met the eligibility criteria, and data regarding their DUP and social/clinical variables were collected.
The median (mean) DUP of our cohort was 10.5 (34.6) months. Longer DUP was associated with younger age at onset, older age at first consultation, less educational attainment, insidious mode of onset and not being accompanied by another person at first consultation. After adjusting for confounding factors, age at onset, age at first consultation and mode of onset remained significantly and independently associated with DUP. In terms of treatment and response, longer DUP was associated with less antipsychotics prescribed upon first visit, and worse Clinical Global Impression Severity and Improvement scores after 1 year.
The patients treated in a rural/suburban region of Japan had a long DUP, and shortening their DUP through promoting family involvement could improve their outcomes.
我们在日本农村/郊区地区，调查了精神分裂症患者的未治疗精神病期（DUP）及其社会和临床相关性。
我们对来自高知县 11 家医院的首发精神病患者进行了回顾性队列研究。共有 108 名符合入选标准的患者，收集了他们的 DUP 及社会/临床变量的数据。
我们队列的中位（平均）DUP 为 10.5（34.6）个月。较长的 DUP 与发病年龄较小、首次就诊年龄较大、受教育程度较低、隐匿性发病模式以及首次就诊时无人陪同有关。在调整了混杂因素后，发病年龄、首次就诊年龄和发病模式仍与 DUP 显著独立相关。在治疗和反应方面，较长的 DUP 与首次就诊时开具的抗精神病药物较少有关，且在 1 年后的临床总体印象严重程度和改善评分更差。
在日本农村/郊区地区治疗的患者 DUP 较长，通过促进家庭参与缩短 DUP 可能会改善他们的结局。
