title: Is duration of illness really influencing outcome in major psychoses?
abstract: BACKGROUND
  An increasing number of studies identifies the duration of illness (DI) as an important predictor of outcome in patients affected by major psychoses (MP). The aim of the present paper was to revise medical literature about DI and its effects on MP, focusing in particular on the relationship between DI and outcome with particular reference to treatment response, suicidal risk, cognitive impairment and social functioning.
  
  
  METHODS
  A search in the main database sources has been performed to obtain a comprehensive overview. Studies with different methodologies (open and double-blinded) have been included, while papers considering other variables such as duration of untreated episode/illness were excluded. MP included the diagnoses of schizophrenia, bipolar disorder and major depressive disorder.
  
  
  RESULTS
  Available data show that DI influences treatment response, suicidal risk and loss of social functioning in schizophrenic patients, while results are more controversial with regard to cognitive impairment. In bipolar disorder, a long DI has been associated with less treatment response, more suicidal risk and cognitive impairment, but more data are needed to draw definitive conclusions. Finally, studies, regarding DI of illness and its predictive value of outcome in major depressive disorder show contradictory results.
  
  
  CONCLUSIONS
  DI appears a negative outcome factor particularly for schizophrenia, while with regard to mood disorders, more data are needed to draw definitive sound conclusions.
authors.affiliation: Alfredo C Altamura, Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , Via F. Sforza 35, 20122, Milan , Italy.
authors.forename: Alfredo Carlo
authors.initials: AC
authors.lastname: Altamura
authors.forename: Marta
authors.initials: M
authors.lastname: Serati
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Buoli
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D059020:Suicidal Ideation; D016896:Treatment Outcome
keywords: Duration of illness (DI); Major psychoses (MP); Outcome