title: Demographic, socio-environmental, and substance-related predictors of duration of untreated psychosis (DUP).
abstract: OBJECTIVE
  Longer duration of untreated psychosis (DUP) is associated with poorer early-course and long-term outcomes, and is a target of early detection and intervention efforts. Given the paucity of research on childhood and adolescent stressors (e.g., maltreatment and neighborhood disorder) as potential predictors of DUP, limited research on premorbid substance use as a determinant of DUP, and inconclusive findings on the association between DUP and neurocognition, we conducted three sets of analyses to address these issues. Mode of onset of psychosis was also considered, given its established role as an illness-level correlate of DUP.
  
  
  METHODS
  We rigorously assessed DUP and other pertinent variables in 180 predominantly African American, low-income, and socially disadvantaged first-episode psychosis patients hospitalized in five psychiatric units.
  
  
  RESULTS
  Mode of onset of psychosis, prior incarceration, and the level of childhood/adolescent maltreatment were all significant independent predictors of DUP. Regarding premorbid substance use, having ever used cannabis and the amount of premorbid alcohol use were significantly associated with DUP. None of the seven neurocognitive domains assessed were even modestly, or clinically meaningfully, associated with DUP.
  
  
  CONCLUSIONS
  These and other findings on DUP may be informative for early detection and intervention services. For example, such services might benefit from special outreach to criminal justice settings and disadvantaged neighborhoods, and to young people likely to have a history of childhood/adolescent maltreatment and gradually developing psychotic symptoms.
authors.affiliation: The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Broussard
authors.forename: Mary E
authors.initials: ME
authors.lastname: Kelley
authors.forename: Claire Ramsay
authors.initials: CR
authors.lastname: Wan
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Cristofaro
authors.forename: Anthony
authors.initials: A
authors.lastname: Crisafio
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Haggard
authors.forename: Neely L
authors.initials: NL
authors.lastname: Myers
authors.forename: Thomas
authors.initials: T
authors.lastname: Reed
authors.forename: Michael T
authors.initials: MT
authors.lastname: Compton
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D017668:Age of Onset; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D003710:Demography; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D011203:Poverty / Q000523:psychology*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childhood maltreatment; Duration of untreated psychosis; First-episode psychosis; Psychosis; Schizophrenia; Treatment delay