title: Duration of untreated psychosis predicts functional and clinical outcome in children and adolescents with first-episode psychosis: a 2-year longitudinal study.
abstract: Longer duration of untreated psychosis (DUP) in adult patients with first-episode psychosis (FEP) has been associated with poor clinical and social outcomes. We aimed to estimate the influence of DUP on outcome at 2-year follow-up in subjects with an early-onset (less than 18 years of age) FEP of less than 6 months' duration. A total of 80 subjects (31.3% females, mean age 16.0±1.8 years) were enrolled in the study. The influence of DUP on outcome was estimated using multiple regression models (two linear models for influence of DUP on the C-GAF at 2 years and C-GAF change through the follow-up period, and a logistic model for influence of DUP on 41 PANSS remission at 2 years in schizophrenia patients (n=47)). Mean DUP was 65.3±54.7 days. Median DUP was 49.5 days. For the whole sample (n=80), DUP was the only variable significantly related to C-GAF score at 2-year follow-up (Beta=-0.13, p<0.01), while DUP and premorbid adjustment (Beta=-0.01, p<0.01; and Beta=-0.09, p=0.04, respectively) were the only variables significantly related to C-GAF change. In schizophrenia patients, DUP predicted both C-GAF score at 2 years and C-GAF change, while in patients with affective psychosis (n=22), DUP was unrelated to outcome. Lower baseline C-GAF score (OR=0.91, p<0.01) and shorter DUP (OR=0.98, p=<0.01) were the only variables that significantly predicted clinical remission in schizophrenia patients. In conclusion, longer DUP was associated with lower C-GAF at 2 years, less increase in C-GAF, and lower rates of clinical remission in early-onset FEP. Our findings support the importance of early detection programs, which help shorten DUP.
authors: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain. Electronic address: david.fraguas@cibersam.es.
authors: David
authors: D
authors: Fraguas
authors: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
authors: Angel
authors: A
authors: Del Rey-Mejías
authors: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
authors: Carmen
authors: C
authors: Moreno
authors: Department of Child and Adolescent Psychiatry and Psychology, SGR-111, CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clínic of Barcelona, Spain; Department of Psychiatry and Psychobiology, University of Barcelona, Spain.
authors: Josefina
authors: J
authors: Castro-Fornieles
authors: Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
authors: Montserrat
authors: M
authors: Graell
authors: Child Psychiatry Unit, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain.
authors: Soraya
authors: S
authors: Otero
authors: Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Vitoria, CIBERSAM, Spain.
authors: Ana
authors: A
authors: Gonzalez-Pinto
authors: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
authors: Dolores
authors: D
authors: Moreno
authors: Department of Child and Adolescent Psychiatry and Psychology, SGR-111, CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clínic of Barcelona, Spain; Department of Psychiatry and Psychobiology, University of Barcelona, Spain.
authors: Inmaculada
authors: I
authors: Baeza
authors: Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Vitoria, CIBERSAM, Spain.
authors: Mónica
authors: M
authors: Martínez-Cengotitabengoa
authors: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
authors: Celso
authors: C
authors: Arango
authors: Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
authors: Mara
authors: M
authors: Parellada
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D012044:Regression Analysis; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D012565:Schizophrenic Psychology
keywords: Adolescent; Affective psychosis; Bipolar disorder; Duration of untreated psychosis (DUP); First-episode psychosis (FEP); Outcome; Remission; Schizophrenia