Duration of untreated psychosis: Impact of the definition of treatment onset on its predictive value over three years of treatment.

Details

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State: Public
Version: Author's accepted manuscript
Serval ID
serval:BIB_706A61AC7241
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Duration of untreated psychosis: Impact of the definition of treatment onset on its predictive value over three years of treatment.
Journal
Journal of psychiatric research
Author(s)
Golay P., Alameda L., Baumann P., Elowe J., Progin P., Polari A., Conus P.
ISSN
1879-1379 (Electronic)
ISSN-L
0022-3956
Publication state
Published
Issued date
06/2016
Peer-reviewed
Oui
Volume
77
Pages
15-21
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
While reduction of DUP (Duration of Untreated Psychosis) is a key goal in early intervention strategies, the predictive value of DUP on outcome has been questioned. We planned this study in order to explore the impact of three different definition of "treatment initiation" on the predictive value of DUP on outcome in an early psychosis sample.
221 early psychosis patients aged 18-35 were followed-up prospectively over 36 months. DUP was measured using three definitions for treatment onset: Initiation of antipsychotic medication (DUP1); engagement in a specialized programme (DUP2) and combination of engagement in a specialized programme and adherence to medication (DUP3).
10% of patients never reached criteria for DUP3 and therefore were never adequately treated over the 36-month period of care. While DUP1 and DUP2 had a limited predictive value on outcome, DUP3, based on a more restrictive definition for treatment onset, was a better predictor of positive and negative symptoms, as well as functional outcome at 12, 24 and 36 months. Globally, DUP3 explained 2 to 5 times more of the variance than DUP1 and DUP2, with effect sizes falling in the medium range according to Cohen.
The limited predictive value of DUP on outcome in previous studies may be linked to problems of definitions that do not take adherence to treatment into account. While they need replication, our results suggest effort to reduce DUP should continue and aim both at early detection and development of engagement strategies.

Keywords
Adolescent, Adult, Antipsychotic Agents/therapeutic use, Female, Follow-Up Studies, Humans, Male, Medication Adherence, Prospective Studies, Psychiatric Status Rating Scales, Psychotic Disorders/epidemiology, Psychotic Disorders/psychology, Psychotic Disorders/therapy, Schizophrenia/epidemiology, Schizophrenia/therapy, Schizophrenic Psychology, Time-to-Treatment, Treatment Outcome, Young Adult, Duration of untreated psychosis, Early psychosis, First episode psychosis, Treatment adherence
Pubmed
Web of science
Open Access
Yes
Create date
22/02/2016 12:40
Last modification date
13/01/2021 21:35
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