The impact of the duration of untreated psychosis prior to first psychiatric admission on the 15-year outcome in schizophrenia

Objective: There is a large amount of evidence to support the hypothesis that the duration of untreated psychosis (DUP) prior to first psychiatric admission adversely affects acute treatment response and short-term outcome in schizophrenia. However, only few prospective studies have attempted to address a possible association between DUP and long-term outcome. Method: Fifty-eight DSM-III-R schizophrenic patients were assessed at their first psychiatric admission and after a 15-year course of the illness. The 15-year outcome in different domains was compared between patients with different DUPs prior to the first psychiatric admission. Results: A longer DUP was associated with more pronounced negative, positive and general psychopathological symptoms as well as a lower global functioning 15 years after the first psychiatric admission, even after effects of other factors, possibly related to the long-term outcome, were controlled for. Conclusions: The DUP prior to first psychiatric admission adversely affects the long-term outcome in schizophrenia. The findings underline the importance of establishing health service programs for early detection and treatment of schizophrenic patients with the aim to shorten the DUP and to consequently improve the course and outcome of schizophrenic patients. (C) 2002 Elsevier Science B.V. All rights reserved.