title: Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis.
abstract: BACKGROUND
  Duration of untreated psychosis (DUP) is one of the few potentially modifiable predictors of outcomes of schizophrenia. Long DUP as a predictor of poor short-term outcome has been addressed in previous meta-analyses, but the long-term effects of DUP remain unclear.
  
  
  OBJECTIVE
  To analyse the associations between DUP and long-term outcomes of schizophrenia.
  
  
  METHODS
  A systematic literature search was performed using seven electronic databases and manual searches. Random effects weighted meta-analysis with correlation coefficients was used to pool the results.
  
  
  RESULTS
  We identified 3493 unique publications, from which 33 samples met our predefined selection criteria. Long DUP correlated statistically significantly with poor general symptomatic outcome, more severe positive and negative symptoms, lesser likelihood of remission and poor social functioning and global outcome (correlations 0.13-0.18). Long DUP was not associated with employment, quality of life or hospital treatment.
  
  
  CONCLUSIONS
  The small but mostly consistent correlation between long DUP and poor outcome indicates that early intervention in psychosis may have at least subtle positive effects on the long-term course of illness.
authors.affiliation: Matti Penttilä, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Erika Jääskeläinen, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu; Noora Hirvonen, MSc, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Faculty of Humanities, Information Studies, Oulu; Matti Isohanni, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Jouko Miettunen, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Penttilä
authors.affiliation: Matti Penttilä, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Erika Jääskeläinen, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu; Noora Hirvonen, MSc, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Faculty of Humanities, Information Studies, Oulu; Matti Isohanni, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Jouko Miettunen, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu, Finland.
authors.forename: Erika
authors.initials: E
authors.lastname: Jääskeläinen
authors.affiliation: Matti Penttilä, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Erika Jääskeläinen, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu; Noora Hirvonen, MSc, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Faculty of Humanities, Information Studies, Oulu; Matti Isohanni, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Jouko Miettunen, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu, Finland.
authors.forename: Noora
authors.initials: N
authors.lastname: Hirvonen
authors.affiliation: Matti Penttilä, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Erika Jääskeläinen, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu; Noora Hirvonen, MSc, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Faculty of Humanities, Information Studies, Oulu; Matti Isohanni, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Jouko Miettunen, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Isohanni
authors.affiliation: Matti Penttilä, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Erika Jääskeläinen, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu; Noora Hirvonen, MSc, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Faculty of Humanities, Information Studies, Oulu; Matti Isohanni, MD, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Oulu University Hospital, Oulu; Jouko Miettunen, PhD, University of Oulu, Institute of Clinical Medicine, Department of Psychiatry, and Institute of Health Sciences, and Oulu University Hospital, and Medical Research Center Oulu, Finland.
authors.forename: Jouko
authors.initials: J
authors.lastname: Miettunen
mesh_terms: D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D011379:Prognosis; D011618:Psychotic Disorders / Q000453:epidemiology / Q000628:therapy*; D012559:Schizophrenia / Q000453:epidemiology / Q000628:therapy*; D013997:Time Factors