Mode of onset of psychosis and family involvement in help-seeking as determinants of duration of untreated psychosis.
BACKGROUND
The duration of untreated psychosis (DUP) is a potentially modifiable determinant of the early course of nonaffective psychotic disorders, though a paucity of research has addressed determinants of DUP. Recent data from London and Nottingham, UK indicated that a shorter DUP was predicted by: (1) an acute mode of onset, (2) employment, and (3) active involvement of at least one family member in seeking evaluation (Morgan et al. Br J Psychiatry 189:446-452, 2006). The present analysis was conducted in an effort to replicate those findings in a predominantly low-income, urban, African American sample.


METHODS
DUP and the three key predictors of interest were assessed using standardized procedures. All analytic plans replicated those of Morgan and colleagues (Morgan et al. Br J Psychiatry 189:446-452, 2006) to the largest extent possible. Sufficient information was available to rate DUP for 73 patients.


RESULTS
The median DUP was 23.4 weeks. Bivariate tests, survival analysis, and Cox regression revealed that an insidious mode of onset was associated with a substantially longer DUP compared with an acute onset, and that family involvement in help-seeking was independently associated with a longer duration.


CONCLUSIONS
While mode of onset is a reliable illness-related determinant of DUP, further research is needed on the complex ways in which family-related variables influence DUP.
Compton
Michael T
MT
Dept. of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA. mcompto@emory.edu
Chien
Victoria H
VH
Leiner
Amy S
AS
Goulding
Sandra M
SM
Weiss
Paul S
PS
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D004651:Employment; D005190:Family / Q000523:psychology; D005260:Female; D005845:Georgia; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology* / Q000706:statistics & numerical data; D011203:Poverty; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy; D012565:Schizophrenic Psychology; D012944:Social Support; D016019:Survival Analysis; D013997:Time Factors; D014505:Urban Population; D044465:White People / Q000523:psychology; D055815:Young Adult