Clinical and Social Determinants of Duration of Untreated Psychosis (DUP)

Abstract

I. Introduction

DUP is defined as the period between the onset of psychotic symptoms and the beginning of treatment. DUP is often prolonged and associated with poor prognosis.

II. Objectives

*Identify the DUP in a population of patients hospitalized, for a first episode of psychosis,

in the psychiatric “A” service in Sfax Tunisia.

* Investigate the clinical and social determinants of DUP.

III. Methods

This is a retrospective study of 50 cases of patients, with a first episode of psychosis, admitted to the psychiatric “A” service during the month of August 2014.

Sociodemographic and clinical characteristics were summarized using a comprehensive semi structured interview.

IV. Results

Sociodemographic data:

The average age of our patients was 37 years.

74% of participants were male.

62% of patients were single.

76% had a low socioeconomic level.

Clinical data

The mean DUP was 72.13 weeks with a range of 0 weeks to 336 weeks.

Data analysis shows that longer DUP was significantly correlated with:

The insidious onset (p = 0.00),

The late age at onset (p = 0.01),

The predominance of negative symptoms (p = 0.04),

The illiteracy (p = 0.008),

The absence of family involvement in help-seeking (p = 0.01).

There was no evidence of an association between DUP and any of the other variables considered: gender, living alone, socioeconomic level and subtypes of schizophrenia.

V. Conclusion

The present findings suggest that DUP is influenced both by aspects of the clinical course and by the social context.