Abstract

BackgroundLonger duration of untreated psychosis (DUP) predicts worse response to treatment and functional outcomes in first episode of schizophrenia (FES). Longer DUP also seem to particulary affect the severity of negative symptoms, but most studies enrolled previously medicated patients and did not focus on differential effects on schizophrenia symptomatic dimensions. This study investigates how DUP influences the five dimensions of symptoms of schizophrenia on antipsychotic naïve FEP patients before and after two months of treatment.MethodsDrug-naïve patients at FES (n = 97) were recruited from the Inpatient Psychiatric Unit of Santa Casa de Misericórdia de São Paulo (Sao Paulo, Brazil), between 2011 and 2016. Subjects were assessed at hospital admission and after two months of follow up. All patients were treated with antipsychotics after the diagnosis was confirmed with the Structured Clinical Interview for DSM-IV (SCID-I). The Positive and Negative Syndrome Scale (PANSS) was administered at baseline and after two months of treatment. The PANSS items were grouped in five factors: positive, negative, disorganized/cognitive, mood/depression and excitement/hostility factors. The factors percentage reduction from baseline after treatment were correlated with the DUP, controlled for sex, age, years of education.ResultsThe mean years of education of the sample was 9.2 (± 2.6 SD), mean age was 24.9 (± 7.0 SD), 62.9% were male and 42.7% were unemployed or had stopped their studies because of symptoms. Pearson correlation coefficients of the factors with DUP were: Positive = - 0.311 (p < 0.001); Negative= -0.340 (p < 0.001); Disorganized = -0.188 (p = 0.033); Hostility = -0.201 (p= 0.023); Depression = 0.030 (p = 0.389).DiscussionShorter DUP enhanced the early response to treatment in the positive, negative, disorganized and hostility dimensions. In line with the literature, our findings support that reducing the DUP may be one of the few interventions for a more favorable response to treatment on negative symptoms.

Highlights

  • Longer duration of untreated psychosis (DUP) predicts worse response to treatment and functional outcomes in first episode of schizophrenia (FES)

  • Longer DUP seem to particulary affect the severity of negative symptoms, but most studies enrolled previously medicated patients and did not focus on differential effects on schizophrenia symptomatic dimensions

  • This study investigates how DUP influences the five dimensions of symptoms of schizophrenia on antipsychotic naïve FEP patients before and after two months of treatment

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Summary

Poster Session III

Disorder at the time of their death, 10 met criteria for a psychotic disorder and 13 met criteria for the presence of both depression and psychosis. As compared to suicide completers with a depressive disorder, the psychotic cases were more likely to be younger (t = 2.18, p < .05), unmarried (χ2 = 3.13, p < .08), unemployed at the time of their death (χ2 = 9.75, p < .01), and more likely to meet criteria for cannabis abuse (χ2 = 3.75, p < .06). The psychotic patients were less likely to rely on alcohol to lower their inhibitions about committing a suicidal act, suggesting other factors need to be addressed in prevention efforts Patients may allow their psychotic thinking to guide their behavior, and when combined with depression can result in self-destructive actions. Beatriz Yukie Elias, Daniela Koga Tonsig, Bruno Bertolucci*,1, Cristiano Noto, Daniel Azevedo Cavalcante, Quirino Cordeiro, Rodrigo Bressan, Ary Gadelha1 1Federal University of Sao Paolo; 2Santa Casa de misericordia de São Paulo

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