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The role of treatment delay in predicting 5-year outcomes in an early intervention program

Published online by Cambridge University Press:  18 July 2011

R. M. G. Norman ,
R. Manchanda ,
D. Windell ,
R. Harricharan ,
S. Northcott  and
L. Hassall
R. M. G. Norman*
Affiliation:
Prevention and Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, ON, Canada
R. Manchanda
Affiliation:
Prevention and Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, ON, Canada
D. Windell
Affiliation:
Prevention and Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, ON, Canada
R. Harricharan
Affiliation:
Prevention and Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, ON, Canada
S. Northcott
Affiliation:
Prevention and Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, ON, Canada
L. Hassall
Affiliation:
Prevention and Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, ON, Canada
*
*Address for correspondence: R. M. G. Norman, Ph.D., C.Psych., A2-643, LHSC-VH, 800 Commissioners Road E, London, ON, CanadaN6A 5W9. (Email: rnorman@uwo.ca)
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Abstract

Background

Past research on the relationship between treatment delay and outcomes for first-episode psychosis has primarily focused on the role of duration of untreated psychosis (DUP) in predicting symptomatic outcomes up to 2 years. In the current study we examine the influence of both DUP and duration of untreated illness (DUI) on symptoms and functioning at 5 years follow-up while controlling for other early characteristics.

Method

A total of 132 patients with first-episode psychosis and treated in an early intervention program were prospectively followed up for 5 years. Outcomes assessed included positive and negative symptoms, overall functioning, weeks on disability pension and weeks of full-time competitive employment.

Results

While DUP showed a significant correlation with level of positive symptoms at follow-up, this was not independent of pre-morbid social adjustment. DUI emerged as a more robust independent predictor of negative symptoms, social and occupational functioning and use of a disability pension.

Conclusions

Delay between onset of non-specific symptoms and treatment may be a more important influence on long-term functioning for first-episode patients than DUP. This suggests the possible value of treating such signs and symptoms as early as possible regardless of the effectiveness of such interventions in reducing likelihood or severity of psychotic symptoms.

Keywords

Early interventionpsychosistreatment delaytreatment outcomes
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 2 , February 2012 , pp. 223 - 233
Copyright
Copyright © Cambridge University Press 2011

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