Clinical and social determinants of a longer duration of untreated psychosis of schizophrenia in a Japanese population.
OBJECTIVE
To measure the duration of untreated psychosis (DUP) among patients with schizophrenia in a Japanese population and to investigate clinical and social determinants of the DUP.


METHODS
A multicentre, retrospective study at seven medical centres in three cities (Tokyo, Toyama and Kochi) was performed. In total, 150 consecutive patients (78 men) with neuroleptic-naïve first-episode schizophrenia were investigated; their DUP and demographic, clinical and social variables were obtained from their medical charts and analysed.


RESULTS
The intraclass correlation coefficient for the DUP was quite good (ICC = 0.849). The mean DUP of all the subjects attending the seven psychiatric services was 20.3 months, and the median DUP was 6.0 months. Fourteen patients (9.3%) had a DUP of more than 60 months, and 47 patients, or about one-third, had a DUP of more than 24 months. No significant differences in the mean DUPs were observed among the three cities. Patients who were employed or who were students had a significantly shorter DUP (14.3 months). The median DUP for those with an insidious onset of psychosis (n = 85) was 18.0 months, compared with a median of 2.0 months for those with a sudden and acute onset (n = 61). However, no other clinical or social variables examined in this study were associated with differences in the DUP.


CONCLUSIONS
The DUP of patients with schizophrenia is relatively long in Japan. The provision and modification of psychiatric services for easy access and a system for the early recognition and detection of mental illness are needed.
Nishii
Herbert
H
Department of Neuropsychiatry, Toho University School of Medicine, Omori-Nishi, Ota-ku, Tokyo, Japan.
Yamazawa
Ryoko
R
Shimodera
Shinji
S
Suzuki
Michio
M
Hasegawa
Tomonori
T
Mizuno
Masafumi
M
D000293:Adolescent; D000328:Adult; D044466:Asian People; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011618:Psychotic Disorders / Q000175:diagnosis; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012931:Social Environment; D013997:Time Factors