DURATION
OF UNTREATED PSYCHOSIS IS ASSOCIATED WITH A POOR TREATMENT
RESPONSE IN SCHIZOPHRENIA
J. Schröder,
S. Bachmann*, D. Weimer, S. Demisch, J. Hoffmann, F. Resch and Ch
Mundt. Depart. Of Psychiatry, Univ. of Heidelberg, D-69115
Heidelberg
Recent studies indicate that a
large proportion of patients with schizophrenia do not seek
treatment immediately after the onset of the disease process, but
remain without treatment for a considerable period of time. In
the present study we investigated the “duration of untreated
psychosis” (DUP) with respect to psychopathological
symptoms, social adaptation, and treatment response in 48 first
admitted patients with DSM-IV schizophreniform disorder,
schizophrenia, or schizoaffective psychosis. DUP was determined
on the basis of the interview for the retrospective assessment of
the onset of schizophrenia (RAOS), the clinical diagnosis was
assessed by using the structured clinical interview for DSM-IV.
Psychopathological symptoms were rated on the positive and
negative symptom scale (PANSS) on admission, after seven days of
treatment and before discharge. Mean DUP was 22.5 ± 51.5 months. Only 26 patients were admitted within
the first six months after the onset of the disease. Patients
with a short (< 6 months) versus a long DUP (> 6 months)
showed a significantly (p <0.005) better treatment response (57 ± 10.8% versus 45.6 ± 13.7%). Moreover, DUP was significantly correlated with persisting negative symptoms and a poor social adaptation. Neither gender, nor duration of hospitalization, nor choice and dosage of neuroleptic medication did account for these effects. Our findings underline previous reports of a delayed initiation of treatment in a considerable proportion of patients. In conclusion, DUP does not only impair social adaptation, but it is also associated with a poor treatment response.