Zhang Ke, Wang Chenxi, Gou Lei, Li Yaxi, Li Cui, Luo Guoshuai, Zhang Xiangyang
Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China.
Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China.
Psychiatry Investig. 2024 Apr;21(4):422-432. doi: 10.30773/pi.2023.0384. Epub 2024 Apr 23.
Studies on duration of untreated psychosis are common in patients with schizophrenia, but few studies have investigated the relationship between duration of untreated illness (DUI) and suicide, especially in patients with chronic schizophrenia. Therefore, we intended to investigate the relationship between DUI and suicide and clinical correlates in patients with chronic schizophrenia.
A total of 1,555 Chinese patients with chronic schizophrenia were enrolled in this study. DUI was measured in years, reflecting the prolonged untreated periods observed in this population. Clinical correlates were assessed, including symptoms, cognitive functioning, and body mass index. Suicidal ideation and attempts were also examined. Statistical analyses, including multivariate models, were employed to investigate the associations between DUI and clinical correlates while controlling for potential confounders.
The study revealed a significant proportion (23.3%) of patients with chronic schizophrenia in China received their first treatment after a 4-year delay, with the longest untreated duration reaching 39 years. Patients with longer DUI exhibited more severe negative symptoms, lower immediate memory scores, a higher likelihood of being overweight, and surprisingly, a reduced likelihood of suicidal ideation and attempts. Each additional year of untreated illness was associated with a 3% decrease in the risk of suicidal ideation and attempts.
The findings underscore the prevalence of extended untreated periods in Chinese patients with chronic schizophrenia and highlight the impact of DUI on negative symptoms, cognitive function, and body weight. Intriguingly, a longer DUI was associated with a lower risk of suicidal ideation and attempts.
关于精神分裂症患者未治疗精神病持续时间的研究很常见，但很少有研究调查未治疗疾病持续时间（DUI）与自杀之间的关系，尤其是在慢性精神分裂症患者中。因此，我们旨在研究慢性精神分裂症患者中DUI与自杀及临床相关因素之间的关系。
本研究共纳入1555名中国慢性精神分裂症患者。DUI以年为单位进行测量，反映该人群中观察到的未治疗期延长情况。评估了临床相关因素，包括症状、认知功能和体重指数。还检查了自杀意念和自杀未遂情况。采用包括多变量模型在内的统计分析方法，在控制潜在混杂因素的同时，研究DUI与临床相关因素之间的关联。
研究显示，中国有相当比例（23.3%）的慢性精神分裂症患者在延迟4年后才接受首次治疗，最长未治疗时间达39年。DUI较长的患者表现出更严重的阴性症状、即时记忆得分更低、超重可能性更高，令人惊讶的是，自杀意念和自杀未遂的可能性降低。未治疗疾病每增加一年，自杀意念和自杀未遂的风险降低3%。
研究结果强调了中国慢性精神分裂症患者未治疗期延长的普遍性，并突出了DUI对阴性症状、认知功能和体重的影响。有趣的是，较长的DUI与较低的自杀意念和自杀未遂风险相关。
