A Study of Influence of Duration of Untreated Psychosis on the Short Term Outcome in First Episode Schizophrenia in Institute of Mental Health, Madras Medical College, Chennai

OBJECTIVE: Previous studies have suggested that there may be an association between longer duration of untreated psychosis and poor outcome in first episode schizophrenia. These studies have been interpreted as providing evidence that untreated psychosis may constitute an active morbid process that is “toxic” to the brain. If untreated psychosis is neurotoxic, this would form a strong basis for early intervention in schizophrenia. METHOD: Fifty seven neuroleptic-naive patients with ICD-10 schizophrenia were evaluated 12 weeks after their first inpatient hospitalization. We examined the relationship between untreated initial psychosis duration (measured from onset of first symptom as well as from first hospital admission) by conducting clinical interview, symptom severity by PANSS and CGI-S scale, premorbid social adjustment by PSA scale, and symptoms improvement after treatment by CGI-I scale. RESULTS: Earlier age at illness onset was associated with longer duration of untreated prodromal psychotic symptoms. There were no significant gender differences in duration of untreated initial psychosis. There is significant association between untreated psychosis duration and premorbid functioning. After controlling for the effects of age at onset, the duration of untreated initial psychosis did not significantly impair subsequent symptom severity or remission of positive symptoms. CONCLUSIONS: Significant negative correlation between duration of untreated psychosis and the age at first presentation and positive symptoms at the time of onset of psychosis. Significant positive correlation between the duration of untreated psychosis and premorbid adjustment. This finding concludes that after controlling of all the confounding factors the duration of untreated psychosis is an independent predictor of outcome as stated in literature. So, early intervention is necessary.