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Untreated psychosis duration predicts non-remission

By jeremyc | August 19, 2010

Source: MedWire News

Duration of untreated psychosis (DUP) predicts short- and long-term failure to achieve remission in first-episode psychosis patients, researchers have found.

“Non-remission of positive psychotic symptoms is quite common in first-episode, non-affective psychosis,” explain Erik Simonsen (University of Copenhagen, Denmark) and team.

To investigate factors associated with failure to achieve remission in first-episode psychosis, the researchers studied data from 301 patients who received treatment at four psychiatric care centers in Denmark between 1997 and 2000.

Information on remission, defined as at least 1 week without psychotic symptoms, at both 3 months and 2 years after first receiving treatment was available for 299 and 293 patients, respectively.

The researchers found that 129 patients were still psychotic at 3 months, and 48 were still psychotic after 2 years.

Overall, 16.4% remained psychotic during the first 2 years of treatment, 15.5% achieved remission for less than 6 months, and 84.5% achieved remission for 6 months or longer.

The only variable that significantly differentiated these three groups was DUP, at 25.5, 14.4, and 6.0 weeks, respectively.

Logistic regression analysis revealed that longer DUP, more negative and less excitative symptoms independently predicted non-remission within the first 3 months. DUP accounted for 13.5% of the variance and negative symptoms for 6.5% in prediction of 3 months non-remission.

Longer DUP was the only significant predictor of non-remission at 2 years.

Simonsen and team conclude: “In general, long DUP, less excitative and more negative symptoms at baseline, and lack of inadequate immediate response to treatment should warn clinicians to pay attention to the more elaborate needs of these patients.”

They add: “A re-evaluation at 3 months should recognize that non-remitted patients with longer DUPs have considerable risk of continuous non-remission.”

Topics: | Schizophrenia |

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