Effect of Duration of Untreated Psychosis on Outcome of Schizophrenia.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 3
Abstract
Duration of untreated psychosis (DUP) as a prognostic indicator of functional outcome is a variable of interest in schizophrenia research. The effect of DUP may be due to the toxic effect of the illness on the brain. Some studies hold that the effect of duration of untreated psychosis on outcome is inconsistent and holds good only for short term outcomes. AIM: To study the effect of duration of untreated psychosis on the outcome of schizophrenia in short and long term. Objectives: To study the duration of untreated psychosis (DUP) at the time of first contact with mental health services, total duration of positive and negative symptoms in the illness course, proportional symptom free period (PSFP) , proportional period of good functioning (PPGF), average functioning in symptom free period ( AFSFP) in a retrospective cohort. Inclusion Criteria: Patints with ICD 10 diagnosis of schizophrenia.Availability of records from the initial visit.Availability of reliable attender. Patient on regular medication (defined as no periods without more than 4 weeks of medication) from records and good compliance Exclusion Criteria: Co morbid Psychiatric/ medical illness, Co morbid substance abuse ( cannabis/ alchohol), discontinued drugs for more than 4 weeks currently Materials And Methods: 100 consecutive patients meeting inclusion and exclusion criteria are assessed with SAPS, SANS and SOFAS ( Social and Occupational Functioning assessment Scale) Results: There was significant difference in the proportional symptom duration between the groups (p=0.006), but the < 10 year duration of illness group contributed to the difference (p=0.010).The negative symptom severity varied significantly with the duration of untreated psychosis(p=0.03) , the significant difference being noted in the >10 year group. The Chlorpromazine equivalent needed by the patient to achieve remission was significantly higher with increasing duration of untreated psychosis (p=0.001), the difference being significant throughout the illness. Conclusion: The duration of untreated psychosis influences the outcome of schizophrenia patients. Increasing DUP is directly proportional to the proportional symptomatic period , negative symptoms and Chlorpromazine dosage required for maintaining remission. The effect of DUP on proportional symptomatic period is significant in the short term but loses its significance in the long term. However, the effect of DUP on negative symptom score, becomes more significant with increasing duration of illness.
Authors and Affiliations
Arasi D. M. .
Keywords
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