Duration of psychosis and outcome in first-episode schizophrenia

OBJECTIVE: This study was undertaken to assess the potential effect of duration of untreated illness on outcome in a group of first-episode schizophrenic patients. METHOD: Seventy patients with schizophrenia diagnosed according to the Research Diagnostic Criteria entered the study and were followed...

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Veröffentlicht in:The American journal of psychiatry 1992-09, Vol.149 (9), p.1183-1188
Hauptverfasser: LOEBEL, A. D, LIEBERMAN, J. A, ALVIR, J. M. J, AYERHOFF, D. I, GEISLER, S. H, SZYMANSKI, S. R
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container_end_page 1188
container_issue 9
container_start_page 1183
container_title The American journal of psychiatry
container_volume 149
creator LOEBEL, A. D
LIEBERMAN, J. A
ALVIR, J. M. J
AYERHOFF, D. I
GEISLER, S. H
SZYMANSKI, S. R
description OBJECTIVE: This study was undertaken to assess the potential effect of duration of untreated illness on outcome in a group of first-episode schizophrenic patients. METHOD: Seventy patients with schizophrenia diagnosed according to the Research Diagnostic Criteria entered the study and were followed for up to 3 years. All patients received standardized treatment and uniform assessments both during the acute phase of their illness and throughout the follow-up period. Outcome was measured in terms of time to remission of acute psychotic symptoms as well as degree of symptom remission. RESULTS: The mean duration of psychotic symptoms before initial treatment was 52 weeks, preceded by a substantial prepsychotic period. According to survival analysis, duration of illness before treatment was found to be significantly associated with time to remission as well as with level of remission. The effect of duration of illness on outcome remained significant when diagnosis and gender variables, themselves associated with outcome, were controlled in a regression analysis. Duration of illness was not correlated with age at onset, mode of onset, premorbid adjustment, or severity of illness at entry into the study. CONCLUSIONS: Duration of psychosis before treatment may be an important predictor of outcome in first-episode schizophrenia. Acute psychotic symptoms could reflect an active morbid process which, if not ameliorated by neuroleptic drug treatment, may result in lasting morbidity. Further implications of these findings are discussed.
doi_str_mv 10.1176/ajp.149.9.1183
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D ; LIEBERMAN, J. A ; ALVIR, J. M. J ; AYERHOFF, D. I ; GEISLER, S. H ; SZYMANSKI, S. R</creator><creatorcontrib>LOEBEL, A. D ; LIEBERMAN, J. A ; ALVIR, J. M. J ; AYERHOFF, D. I ; GEISLER, S. H ; SZYMANSKI, S. R</creatorcontrib><description>OBJECTIVE: This study was undertaken to assess the potential effect of duration of untreated illness on outcome in a group of first-episode schizophrenic patients. METHOD: Seventy patients with schizophrenia diagnosed according to the Research Diagnostic Criteria entered the study and were followed for up to 3 years. All patients received standardized treatment and uniform assessments both during the acute phase of their illness and throughout the follow-up period. Outcome was measured in terms of time to remission of acute psychotic symptoms as well as degree of symptom remission. RESULTS: The mean duration of psychotic symptoms before initial treatment was 52 weeks, preceded by a substantial prepsychotic period. According to survival analysis, duration of illness before treatment was found to be significantly associated with time to remission as well as with level of remission. The effect of duration of illness on outcome remained significant when diagnosis and gender variables, themselves associated with outcome, were controlled in a regression analysis. Duration of illness was not correlated with age at onset, mode of onset, premorbid adjustment, or severity of illness at entry into the study. CONCLUSIONS: Duration of psychosis before treatment may be an important predictor of outcome in first-episode schizophrenia. Acute psychotic symptoms could reflect an active morbid process which, if not ameliorated by neuroleptic drug treatment, may result in lasting morbidity. Further implications of these findings are discussed.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/ajp.149.9.1183</identifier><identifier>PMID: 1503130</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>Adult ; Adult and adolescent clinical studies ; Biological and medical sciences ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Psychiatric Status Rating Scales ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychoses ; Psychosis ; Psychotic Disorders - diagnosis ; Psychotic Disorders - drug therapy ; Psychotic Disorders - psychology ; Psychotropic Drugs - therapeutic use ; Schizophrenia ; Schizophrenia - diagnosis ; Schizophrenia - drug therapy ; Schizophrenic Psychology ; Severity of Illness Index ; Social research ; Survival Analysis ; Time Factors ; Treatment Outcome</subject><ispartof>The American journal of psychiatry, 1992-09, Vol.149 (9), p.1183-1188</ispartof><rights>1992 INIST-CNRS</rights><rights>Copyright American Psychiatric Association Sep 1992</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a476t-ca7e0330d2ae457ff0478440878502ad4bb028f620720387f9b78dc735fc1a5e3</citedby><cites>FETCH-LOGICAL-a476t-ca7e0330d2ae457ff0478440878502ad4bb028f620720387f9b78dc735fc1a5e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ajp.149.9.1183$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ajp.149.9.1183$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,780,784,2859,21629,27869,27924,27925,77791,77792</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=5465155$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1503130$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LOEBEL, A. 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D</au><au>LIEBERMAN, J. A</au><au>ALVIR, J. M. J</au><au>AYERHOFF, D. I</au><au>GEISLER, S. H</au><au>SZYMANSKI, S. R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Duration of psychosis and outcome in first-episode schizophrenia</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>1992-09-01</date><risdate>1992</risdate><volume>149</volume><issue>9</issue><spage>1183</spage><epage>1188</epage><pages>1183-1188</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>OBJECTIVE: This study was undertaken to assess the potential effect of duration of untreated illness on outcome in a group of first-episode schizophrenic patients. METHOD: Seventy patients with schizophrenia diagnosed according to the Research Diagnostic Criteria entered the study and were followed for up to 3 years. All patients received standardized treatment and uniform assessments both during the acute phase of their illness and throughout the follow-up period. Outcome was measured in terms of time to remission of acute psychotic symptoms as well as degree of symptom remission. RESULTS: The mean duration of psychotic symptoms before initial treatment was 52 weeks, preceded by a substantial prepsychotic period. According to survival analysis, duration of illness before treatment was found to be significantly associated with time to remission as well as with level of remission. The effect of duration of illness on outcome remained significant when diagnosis and gender variables, themselves associated with outcome, were controlled in a regression analysis. Duration of illness was not correlated with age at onset, mode of onset, premorbid adjustment, or severity of illness at entry into the study. CONCLUSIONS: Duration of psychosis before treatment may be an important predictor of outcome in first-episode schizophrenia. Acute psychotic symptoms could reflect an active morbid process which, if not ameliorated by neuroleptic drug treatment, may result in lasting morbidity. Further implications of these findings are discussed.</abstract><cop>Washington, DC</cop><pub>American Psychiatric Publishing</pub><pmid>1503130</pmid><doi>10.1176/ajp.149.9.1183</doi><tpages>6</tpages></addata></record>
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subjects Adult
Adult and adolescent clinical studies
Biological and medical sciences
Female
Follow-Up Studies
Humans
Male
Medical sciences
Psychiatric Status Rating Scales
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Psychosis
Psychotic Disorders - diagnosis
Psychotic Disorders - drug therapy
Psychotic Disorders - psychology
Psychotropic Drugs - therapeutic use
Schizophrenia
Schizophrenia - diagnosis
Schizophrenia - drug therapy
Schizophrenic Psychology
Severity of Illness Index
Social research
Survival Analysis
Time Factors
Treatment Outcome
title Duration of psychosis and outcome in first-episode schizophrenia
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