Clinical and psychopathological correlates of duration of untreated illness (DUI) in affective spectrum disorders

Affective disorders represent psychopathological entities lying on a continuum, characterized by high prevalence and functional impairment. A delay in treatment initiation might increase the burden associated with affective spectrum disorders. The present study was aimed at analyzing the correlates of a long duration of untreated illness (DUI) in these conditions. We recruited subjects diagnosed with affective disorders, both in- and outpatients, and collected information concerning socio-demographic, clinical, and psychopathological characteristics. Long DUI was defined according to previous research criteria as > 2 years for Bipolar Disorders or > 1 year for Depressive Disorders. Bivariate analyses were performed to compare subjects with a long and short DUI ( p < 0.05). A logistic regression was operated to evaluate the correlates of long DUI. In the present sample ( n = 135), 34.1% ( n = 46) subjects showed a long DUI. This subgroup presented with more physical comorbidities ( p = 0.003), higher body mass index (BMI) ( p < 0.001), more frequent anxiety onset ( p = 0.018), younger onset age ( p = 0.042), and more severe depressive symptoms (Hamilton Depression Rating Scale item 1-depressed mood ( p = 0.032) and item 2-guilt feelings ( p = 0.018)). At the logistic regression, higher severity of depressed mood (OR 1.568), higher BMI (OR 1.264), and younger age at onset (OR 0.935) were associated with long DUI. The present study confirmed a possible role of DUI as a construct underpinning higher clinical severity in affective spectrum disorders, possibly linked to worse illness course and unfavorable outcomes. Intervention strategies targeting physical comorbidi-ties and depressive symptoms severity may decrease disease burden in subjects with a long DUI. (c) 2022 Elsevier B.V. and ECNP. All rights reserved.