Duration of untreated psychosis as a predictor of outcome in first-episodeschizophrenia: a retrospective study

The aim of this study was to investigate possible clinical predictors of th e outcome of first-episode schizophrenia. The clinical charts of the first episode of psychosis and the follow-up period over at least 4 years for 67 DSM-IH-R schizophrenic patients were reviewed. According to the number of p sychotic relapses observed during the follow-up period, patients were sub-d ivided into two groups: mono- and multi-episode patients. The main demograp hic and clinical variables recorded at the first episode were compared betw een the two groups. A logistic regression analysis was performed to test a model for the possible predictors of the two different patterns of outcome. Multi-episode patients had an earlier onset of the illness and a longer "du ration of untreated psychosis" (DUP), defined as the interval between the o nset of the first psychotic symptoms and the first antipsychotic treatment. The Brief Psychiatric Rating Scale (BPRS) total scores were lower and the "avolition/apathy" scores of the scale for the assessment of negative sympt oms (SANS) were higher in multi-episode patients. The logistic regression a nalysis results confirmed the DUP and the pre-treatment BPRS scores to be s ignificant predictors of the outcome. These findings confirm that the timin g in recognizing and treating the early symptoms of schizophrenia, even whe n subtle, is a core issue for the clinical management of the disorder. (C) 2001 Elsevier Science B.V. All rights reserved.