title: Duration of active psychosis and first-episode psychosis negative symptoms.
abstract: Duration of untreated psychosis (DUP) has been associated with negative symptoms in several studies; however, longitudinal findings have been inconsistent. No previous study has accounted for active psychosis after presentation, although this could impact on outcomes in a manner similar to DUP.
  
  
  
  We measured Scale for the Assessment of Positive Symptoms at frequent intervals during the 12 months after initial presentation to determine the active psychosis duration for 230 individuals with first-episode psychosis. This duration was added to DUP prior to presentation to create a new variable, duration of active psychosis (DAP). Negative symptoms were divided into expressivity and motivation/pleasure domains as measured by Scale for the Assessment of Negative Symptoms (SANS). The relationship of DUP and DAP with negative symptoms at 24-month follow up was determined and confounders controlled for using regression analysis.
  
  
  
  When DUP and DAP were compared as binary variables with long and short groups, 25.2% of individuals had differing category membership. DAP had a significant uncorrected association with both expressivity domain and motivation/pleasure domains at 24 months; however, relationship with DUP was not significant. DAP remained a significant predictor of 24-month expressivity domain after controlling for potential confounders.
  
  
  
  Active psychosis after presentation is substantial, which is a limitation of DUP studies if active psychosis is considered as the key factor within DUP. DAP is a better predictor of negative symptoms than DUP at 2-year follow up, which suggests this concept requires further research.
authors.affiliation: Prevention and Early Intervention Program for Psychoses (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Lyne
authors.affiliation: Prevention and Early Intervention Program for Psychoses (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec, Canada.|Department of Psychiatry, McGill University Institute, Montreal, Quebec, Canada.
authors.forename: Ridha
authors.initials: R
authors.lastname: Joober
authors.affiliation: Department of Psychiatry, McGill University Institute, Montreal, Quebec, Canada.|Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
authors.affiliation: Prevention and Early Intervention Program for Psychoses (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec, Canada.|Department of Psychiatry, McGill University Institute, Montreal, Quebec, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Lepage
authors.affiliation: Prevention and Early Intervention Program for Psychoses (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec, Canada.|Department of Psychiatry, McGill University Institute, Montreal, Quebec, Canada.|Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
authors.forename: Ashok
authors.initials: A
authors.lastname: Malla
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002908:Chronic Disease; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009042:Motivation; D057181:Pleasure; D062706:Prodromal Symptoms; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D011792:Quebec; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D013997:Time Factors; D055815:Young Adult
keywords: active psychosis; duration of untreated psychosis; first-episode psychosis; negative symptom; schizophrenia