Association between duration of untreated psychosis and executive function in early-onset psychosis

Abstract

• Psychosis can present at an early onset (≤18 years old) which may cause impaired executive function. • Behavior Rating Inventory of Executive Function (BRIEF) can assess executive function and its subdomains-the behavioral regulation (inhibition, shifting, emotional control) and the metacognition (initiate, plan/organize, organization of material, monitor, and working memory) during a period of time (not a one-time testing). • Duration of untreated psychosis showed a significant relationship with executive function, and with both of its two subdomains i.e. the behavioral regulation and metacognition . Psychosis is a severe mental illness that causes impaired executive function (EF). The prolonged duration of untreated psychosis (DUP) is one of the negative factors in the course of psychosis. However, the results of previous studies remain inconsistent. The aim of this study is to find out the association between DUP and all the components of EF, i.e. behavioral regulation and metacognition with all their subdomains. This was a cross-sectional study involving patients with early onset-psychosis aged 5–18 years old. DUP were collected from medical records, whereas sociodemographic data were collected by interview and EF was measured using the Behavior Rating Inventory of Executive Function-Parent Indonesian Version questionnaire. Total 50 subjects were included in the study. The median age of subjects was 15.9 ± 1.9 years old with schizophrenia as majority of diagnosis (58%). Median DUP was 2 (0; 84) months. Subjects were divided into short DUP ( ≤ 2 months) and long DUP (>2 months) group. A significant association was found between long DUP (>2 months) and higher Global Executive Composite (GEC) score indicating poorer function, which consisted of Behavioral Regulation Index (BRI) and Metacognition Index (MI) ( p = 0.001, p = 0.007, p = 0.001, respectively). All subdomains of BRI and MI, except material organization, showed significant associations with DUP. There was a significant association between long DUP (>2 months) and poorer EF in early-onset psychosis.