Department of Public Health, Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Via Liguria 13, 09127 Cagliari, Italy.
Ann Gen Psychiatry. 2012 Aug 2;11(1):21. doi: 10.1186/1744-859X-11-21.
Studies performed to assess the relevance of duration of untreated psychosis (DUP) as a predictor of long-term outcome (i.e. follow-ups of ten years or more) are somewhat limited. The aim of this study was to evaluate the potential association between DUP and very long-term outcome (16-33 yrs) of schizophrenia by means of a retrospective design.
Retrospective data obtained from clinical records were collected regarding DUP and outcome variables (number of hospitalizations; number of attempted suicides; course of illness; GAF scores at last observation) for a cohort of 80 outpatients (52 Males, 28 Females, mean age 51.0+/-11.58 years) affected by schizophrenia according to DSMIVTR attending a university community mental health centre.
Mean duration of follow up was 25.2 +/- 8.68 years; mean duration of untreated psychosis was 49.00 months (range 1-312 mo), with no significant difference according to gender. Patients with a shorter DUP (=/< 1 year) displayed more frequent "favourable" courses of illness (28.9% vs 8.6%) (p = 0.025), more frequent cases with limited (=/< 3) number of hospital admissions (85.7% vs 62.1%) (p = 0.047) and a better functioning (mean GAF score = 50.32+/-16.49 vs 40.26+/-9.60, p = 0.002); regression analyses confirmed that shorter DUP independently predicted a more positive outcome in terms of number of hospital admissions, course of illness, functioning (GAF scores).
A shorter DUP appears to act as a significant predictor of better outcome in schizophrenia even in the very long-term.
评估未治疗精神病持续时间（DUP）作为长期结果（即超过十年的随访）预测因子的研究有些有限。本研究旨在通过回顾性设计评估 DUP 与精神分裂症的超长（16-33 年）结局之间的潜在关联。
从临床记录中收集了回顾性数据，涉及 80 名门诊患者（52 名男性，28 名女性，平均年龄 51.0+/-11.58 岁）的 DUP 和结局变量（住院次数；自杀未遂次数；病程；最后一次观察时的 GAF 评分），这些患者根据 DSM-IV-TR 被诊断为精神分裂症，他们在一所大学社区心理健康中心就诊。
平均随访时间为 25.2+/-8.68 年；未治疗精神病的平均持续时间为 49.00 个月（范围 1-312 个月），性别之间无显著差异。DUP 较短（=/<1 年）的患者表现出更频繁的“有利”病程（28.9% vs 8.6%）（p=0.025），更频繁的有限（=/<3）住院次数（85.7% vs 62.1%）（p=0.047）和更好的功能（平均 GAF 评分=50.32+/-16.49 vs 40.26+/-9.60，p=0.002）；回归分析证实，较短的 DUP 可独立预测住院次数、病程、功能（GAF 评分）方面的更积极结局。
即使在超长时期，DUP 较短似乎也是精神分裂症更好结局的重要预测因子。
