The relationship of duration of untreated psychosis (DUP) to outcome is often invoked in support of early intervention. A prospective study published this week in Schizophrenia Research finds that DUP predicts poorer remission status, more severe positive and negative symptoms, and greater impairment in general functioning, social functioning and quality of life 12 years following a first episode of psychosis, but does not predict employment status (for which education was the only predictor) or independent living (for which age was the only predictor). The relationship between DUP and functional outcome was mediated, in particular, by negative symptoms.
Abstract → Hill, M., Crumlish, N., et al; Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12years. Schizophrenia Research.141 (2) 215-221, November 2012
Note from Kermit Cole, “In the News” editor:
DUP’s impact on outcome is often used to justify early medical intervention, though there is little reason to assume that DUP’s impact is purely (if at all) of a medical nature. Here, the lack of a relationship of DUP with employment, and of DUP’s impact being primarily through negative symptoms, which are by far less the target of medical interventions than positive symptoms, may give premise for questioning the presumption that medical interventions should be the focus of treatment.