One-year effect of changing duration of untreated psychosis in a single catchment area.
BACKGROUND
There is highly replicated positive correlation between longer duration of untreated psychosis and poorer outcome.


OBJECTIVE
To study the effect of early intervention in first psychosis on one-year outcome using an historical quasi-experimental design.


METHODS
We compare the outcome of two samples of first-episode psychosis from the same healthcare district at different time periods. The historical control sample was assessed during 1993-1994, before the establishment of a system for early detection of psychosis. The experimental sample is the early detection sample in the Early Treatment and Intervention in Psychosis study assessed during 1997-2000.


RESULTS
At 1-year follow-up, the early detection group was younger, had a smaller fraction of individuals with schizophrenia, had less severe negative and general symptoms and had more friends in the past year than the historical control group. No differences were found in clinical course (remission, relapse, continuously psychotic) or positive symptoms, but more patients in the early detection sample were treated as outpatients without hospitalisation.


CONCLUSIONS
Early detection of schizophrenia in one healthcare sector is associated with less severe deterioration at 1 year.
Stavanger University Hospital, Psychiatric Clinic, Division for Psychiatry, and Department of Psychiatry, University of Bergen, Norway. tklarsen@online.no
Tor K
TK
Larsen
Ingrid
I
Melle
Svein
S
Friis
Inge
I
Joa
Jan Olav
JO
Johannessen
Stein
S
Opjordsmoen
Erik
E
Simonsen
Per
P
Vaglum
Thomas H
TH
McGlashan
D000293:Adolescent; D000328:Adult; D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000628:therapy; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy