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

Abstract

Objective: This study examines 1 year outcome in patients having first-episode non-affective psychosis, with emphasis on Duration of Untreated Psychosis (DUP) and premorbid functioning, in order to clarify how these factors interact. Method: Forty-three consecutively admitted patients were all rated on the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF), both upon hospitalization and at 1 year follow-up. In addition, premorbid functioning, DUP, duration of hospitalization, and social functioning were rated. Results: Fifty-six per cent were in remission, 18% suffered multiple relapses and 26% were continuously psychotic at 1 year follow-up. Both poor premorbid functioning and long DUP are significantly correlated with more negative symptoms and poorer global functioning at follow-up. Long DUP is also significantly correlated with more positive 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 influence on outcome. Conclusions: these findings strengthen the rationale for establishing health service programs for early detection and treatment of first-onset psychosis