title: The duration of untreated psychosis is associated with social support and temperament.
abstract: The duration of untreated psychosis (DUP) has been suggested to be a modifiable factor influencing psychosis outcome. There are many studies on the factors that predict DUP, although with contradictory findings. Although temperament has been associated with seeking help in other pathologies, studies about how temperament influences DUP are lacking. This study explored the role of temperament (measured by the Eysenck Personality Inventory Questionnaire) on DUP and tested the hypothesis that social support modifies the effects of neuroticism and extraversion on DUP. We evaluated 97 first-episode psychosis patients. The effect of temperament, affective diagnosis and social support (measured by the Social Support Index) on DUP was explored through a multivariate analysis using Cox regression model. Once psychotic symptoms had started, a patient with affective psychosis was 76% more likely to start antipsychotic medications than a patient with non-affective psychosis of comparable time without treatment (adjusted hazard ratio, HR, 1.76; 95% CI, (1.07, 2.9)). There was a significant interaction between diffuse social support and neuroticism (p=0.04). Among patients who had a good diffuse social support, a patient with a high neuroticism score was 45% less likely to start antipsychotic medication than a time-comparable patient with a low neuroticism (HR, 0.55 (0.32, 0.95)). Among patients who had a low neuroticism score, a patient with poor diffuse social support was 56% less likely to start antipsychotic medication than a comparable patient with good support (HR, 0.44 (0.23, 0.86)). In conclusion, patients with affective psychosis had significantly shorter DUPs. In patients with a good diffuse social support, low neuroticism scores were significantly associated with decreased DUP. In patients with low neuroticism scores, a poor diffuse social support was associated with a significant increase in DUP.
authors.affiliation: Grupo Psicosis y Neurodesarrollo, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio /CSIC/Universidad de Sevilla, Unidad de Hospitalizacion de Salud Mental, Sevilla, Spain. miguel.ruiz.veguilla.sspa@juntadeandalucia.es
authors.forename: Miguel
authors.initials: M
authors.lastname: Ruiz-Veguilla
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Barrigón
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Diaz
authors.forename: Maite
authors.initials: M
authors.lastname: Ferrin
authors.forename: Josefa
authors.initials: J
authors.lastname: Moreno-Granados
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Salcedo
authors.forename: Jorge
authors.initials: J
authors.lastname: Cervilla
authors.forename: Manuel
authors.initials: M
authors.lastname: Gurpegui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D013694:Temperament; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents