1Department of Psychiatry, University of Milan, Italy.
Int J Soc Psychiatry. 2013 Dec;59(8):765-70. doi: 10.1177/0020764012456807. Epub 2012 Oct 3.
Several studies show an association between a long duration of untreated illness (DUI) and poor outcome in schizophrenic patients. DUI, in turn, may be influenced by different variables including specific illness-related factors as well as access to local psychiatric services.
The purposes of the present study were to detect differences in terms of DUI among schizophrenics coming from different geographic areas and to evaluate differences in DUI across diagnostic sub-types.
One hundred and twenty-five (125) schizophrenic patients of the Psychiatric Clinic of Milan (n = 51) and Moscow (n = 74) were enrolled. SCID-I was administered to all patients and information about DUI was obtained by consulting clinical charts and health system databases, and by means of clinical interviews with patients and their relatives. DUI was defined as the time between the onset of illness and the administration of the first antipsychotic drug. One-way analyses of variance (ANOVAs) were performed to find eventual differences in terms of DUI across diagnostic sub-types.
Italian patients showed a longer DUI (M = 4.14 years, SD = 4.95) than Russians (M = 1.16 years, SD = 1.43) (F = 24.03, p < .001). DUI was found to be longer in paranoid schizophrenics (M = 3.47 years, SD = 4.19) compared to catatonic patients (M = 0.96 years, SD = 0.94) (F = 3.56, p = .016).
The results of the present study suggest that the different schizophrenic sub-types may differ in terms of DUI, likely due to different clinical severity and social functioning. Studies with larger samples are needed to confirm the data of the present study.
多项研究表明,精神分裂症患者未接受治疗的时间(DUI)与预后不良有关。反过来,DUI 可能受到不同变量的影响,包括特定的疾病相关因素以及获得当地精神科服务的情况。
本研究旨在检测来自不同地理区域的精神分裂症患者在 DUI 方面的差异,并评估不同诊断亚型的 DUI 差异。
纳入米兰(n=51)和莫斯科(n=74)精神科诊所的 125 名精神分裂症患者。对所有患者进行 SCID-I 诊断,并通过查阅临床病历和健康系统数据库以及对患者及其亲属进行临床访谈,获取 DUI 信息。DUI 定义为发病至首次服用抗精神病药物之间的时间。采用单因素方差分析(ANOVA)来确定不同诊断亚型的 DUI 差异。
意大利患者的 DUI 时间(M=4.14 年,SD=4.95 年)长于俄罗斯患者(M=1.16 年,SD=1.43 年)(F=24.03,p<0.001)。与紧张型患者(M=0.96 年,SD=0.94 年)相比,偏执型精神分裂症患者的 DUI 时间更长(M=3.47 年,SD=4.19 年)(F=3.56,p=0.016)。
本研究结果表明,不同的精神分裂症亚型可能在 DUI 方面存在差异,这可能与不同的临床严重程度和社会功能有关。需要更大样本的研究来验证本研究的数据。