title: Does duration of untreated psychosis predict very long term outcome of schizophrenic disorders? results of a retrospective study.
abstract: BACKGROUND
  Studies performed to assess the relevance of duration of untreated psychosis (DUP) as a predictor of long-term outcome (i.e. follow-ups of ten years or more) are somewhat limited. The aim of this study was to evaluate the potential association between DUP and very long-term outcome (16-33 yrs) of schizophrenia by means of a retrospective design.
  
  
  METHODS
  Retrospective data obtained from clinical records were collected regarding DUP and outcome variables (number of hospitalizations; number of attempted suicides; course of illness; GAF scores at last observation) for a cohort of 80 outpatients (52 Males, 28 Females, mean age 51.0+/-11.58 years) affected by schizophrenia according to DSMIVTR attending a university community mental health centre.
  
  
  RESULTS
  Mean duration of follow up was 25.2 +/- 8.68 years; mean duration of untreated psychosis was 49.00 months (range 1-312 mo), with no significant difference according to gender. Patients with a shorter DUP (=/< 1 year) displayed more frequent "favourable" courses of illness (28.9% vs 8.6%) (p = 0.025), more frequent cases with limited (=/< 3) number of hospital admissions (85.7% vs 62.1%) (p = 0.047) and a better functioning (mean GAF score = 50.32+/-16.49 vs 40.26+/-9.60, p = 0.002); regression analyses confirmed that shorter DUP independently predicted a more positive outcome in terms of number of hospital admissions, course of illness, functioning (GAF scores).
  
  
  CONCLUSIONS
  A shorter DUP appears to act as a significant predictor of better outcome in schizophrenia even in the very long-term.
authors.affiliation: Department of Public Health, Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Via Liguria 13, 09127 Cagliari, Italy. bcarpini@iol.it.
authors.forename: Diego
authors.initials: D
authors.lastname: Primavera
authors.forename: Chiara
authors.initials: C
authors.lastname: Bandecchi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Lepori
authors.forename: Lucia
authors.initials: L
authors.lastname: Sanna
authors.forename: Eraldo
authors.initials: E
authors.lastname: Nicotra
authors.forename: Bernardo
authors.initials: B
authors.lastname: Carpiniello