title: Duration of untreated psychosis: relationship with baseline characteristics and three-year outcome in first-episode psychosis.
abstract: Duration of untreated psychosis (DUP) has been considered as one of the few potentially malleable prognostic factors in psychotic illness. The literature demonstrated that prolonged DUP predicted the level of positive symptoms, but its relationships with negative symptoms and functional outcome were less clear-cut. Thus far, most first-episode studies have been conducted in western countries. Yet, it is known that illness outcome might be modified by socio-cultural factors. In this study, we aimed to examine the impact of DUP on baseline characteristics, clinical and vocational outcomes over 3 years in 700 Chinese young people who presented with first-episode psychosis to a specialized early intervention service in Hong Kong. Our results showed that prolonged DUP was associated with male sex, younger age of onset, schizophrenia-spectrum diagnosis, insidious development of psychosis, fewer baseline positive symptoms and less likelihood of hospitalization at intake. Regression analyses revealed that prolonged DUP was significantly predictive of outcome on positive symptoms, recovery and sustained full-time employment in our first-episode psychosis cohort. Taken together, our study provided further supportive evidence regarding the prognostic value of DUP on illness outcome. Additionally, it suggested that an adverse impact of treatment delay for psychosis may likely be applied across regions of various ethno-cultural backgrounds.
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. changwc@hku.hk
authors.forename: Wing Chung
authors.initials: WC
authors.lastname: Chang
authors.forename: Jennifer Yee Man
authors.initials: JY
authors.lastname: Tang
authors.forename: Christy Lai Ming
authors.initials: CL
authors.lastname: Hui
authors.forename: May Mei Ling
authors.initials: MM
authors.lastname: Lam
authors.forename: Gloria Hoi Yan
authors.initials: GH
authors.lastname: Wong
authors.forename: Sherry Kit Wa
authors.initials: SK
authors.lastname: Chan
authors.forename: Cindy Pui Yu
authors.initials: CP
authors.lastname: Chiu
authors.forename: Dicky Wai Sau
authors.initials: DW
authors.lastname: Chung
authors.forename: Chi Wing
authors.initials: CW
authors.lastname: Law
authors.forename: Steve
authors.initials: S
authors.lastname: Tso
authors.forename: Kathy
authors.initials: K
authors.lastname: Chan
authors.forename: Se Fong
authors.initials: SF
authors.lastname: Hung
authors.forename: Eric Yu Hai
authors.initials: EY
authors.lastname: Chen
mesh_terms: D000328:Adult; D017668:Age of Onset; D004651:Employment / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012565:Schizophrenic Psychology; D012727:Sex Characteristics; D013997:Time Factors; D016896:Treatment Outcome