A case of prolonged duration of untreated psychosis: barriers to treatment and strategies to improve the outcome.

Several factors may contribute to increase in duration of untreated psychosis (DUP). In most cases, early intervention, namely psychopharmacological or psychosocial intervention, is done after first-episode psychosis. It is important to know what factors can contribute to duration of untreated psychosis. During this phase, patients often display unspecific symptoms such as anxiety and depression, personality disorders, and abuse of alcohol or drugs. These symptoms could go unrecognized and, hence, cause a delay in seeking treatment. In addition, functional and social decline frequently occurs in the prodromal phase or in the early course of schizophrenia. The purpose of this paper is to highlight barriers that cause delay in treatment and to review early detection and specific treatment strategies that may help to improve outcomes leading to psychosocial recovery.