Premorbid functioning versus duration of untreated psychosis in 1 year outcome in first-episode psychosis

Objective: This study examines 1 year outcome in patients having first-epis ode non-affective psychosis, with emphasis on Duration of Untreated Psychos is (DUP) and premorbid functioning, in order to clarify how these factors i nteract. Method: Forty-three consecutively admitted patients were all rated on the Positive and Negative Syndrome Scale (PANSS) and the Global Assessm ent of Functioning Scale (GAF), both upon hospitalization and at 1 year fol low-up. In addition, premorbid functioning, DUP, duration of hospitalizatio n, and social functioning were rated. Results: Fifty-six per cent were in r emission, 18% suffered multiple relapses and 26% were continuously psychoti c at 1 year follow-up. Both poor premorbid functioning and long DUP are sig nificantly correlated with more negative symptoms and poorer global functio ning at follow-up. Long DUP is also significantly correlated with more posi tive symptoms. Even when we control for other factors, including premorbid functioning and gender, DUP is a strong predictor of outcome. To a limited degree premorbid functioning and DUP interact, but DUP has an independent i nfluence on outcome. Conclusions: these findings strengthen the rationale f or establishing health service programs for early detection and treatment o f first-onset psychosis (C) 2000 Elsevier Science B.V. All rights reserved.