Duration of untreated illness as a key to early intervention in schizophrenia: a review.

Murru, Andrea; Carpiniello, Bernardo

doi:10.1016/j.neulet.2016.10.003

Cited by 135Schizophrenia research and treatmentMental Health and PsychiatryBipolar Disorder and Treatment

Duration of untreated illness as a key to early intervention in schizophrenia: a review.

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Murru, Andrea, Carpiniello, Bernardo·2018·Neuroscience Letters

DOI 10.1016/j.neulet.2016.10.003

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Abstract

The first psychotic episode is classically viewed as a critical period which management is important in determining the long-term outcome of the schizophrenia (SCZ). For this reason, the duration of untreated illness (DUI), defined as the interval between the onset of the psychiatric disorder and the administration of the first pharmacological treatment, is a clinical variable that has been increasingly investigated due to its potentially modifiable nature and its value as a predictor of outcome. DUI is poorly applicable and highly unreliable in psychosis. The present critical review examines the impact of DUI and its more operative definition of "duration of untreated psychosis" (DUP) in the course and outcome of SCZ, focusing on its epidemiologic, clinical, prognostic factors. Length of DUP has been identified as positively related to a worst treatment response, symptom control and overall functional outcome in SCZ. Negative symptoms appear to be prominently related to longer DUP. Neuroimaging correlates of DUP have not been clearly outlined: few of the studies considering first-episode patients and DUP showed structural abnormalities. A low proportion of significant associations were found mostly in cerebellum and occipital lobe of patients with longer DUP. Also, evidence of an inverse correlation between cognitive alterations and DUP is not conclusive. DUI and DUP are multidimensional constructs that imply both intrinsic, illness related (e.g. subtle symptoms at onset) and extrinsic factors (e.g. access to mental health services), so that from its study sprouted in the last decades First-Episode Units, aimed at providing secondary prevention in SCZ such as providing a timely diagnosis and treatment to patients experiencing their first psychotic episode. Early intervention seems to ensure a shortened DUP, especially for people presenting with brief limited intermittent psychotic symptoms, and, ultimately, ensure a more favorable prognosis for patients affected by SCZ.

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Our social assessment revealed a tremendous negative impact of severity of positive symptoms and crisis-associated hospitalization on patients' QoL.
“Our social assessment in turn revealed a tremendous negative impact of the severity of positive symptoms and crisis-associated hospitalization on patients’ QoL (27, 80–82).”
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Effect of delaying treatment of first-episode psychosis on symptoms and social outcomes: a longitudinal analysis and modelling study
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Duration of untreated illness in a cross-diagnostic sample of obsessive-compulsive disorder, panic disorder, and social anxiety disorder
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Duration of active psychosis and functional outcomes in first-episode non-affective psychosis
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Clinical predictors of antipsychotic treatment resistance: Development and internal validation of a prognostic prediction model by the STRATA-G consortium
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Duration of active psychosis during early phases of the illness and functional outcome: The PAFIP 10-year follow-up study
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First help-seeking attempt before and after psychosis onset: measures of delay and aversive pathways to care
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Prediction of Early Symptom Remission in Two Independent Samples of First-Episode Psychosis Patients Using Machine Learning
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Authors: Murru, A., & Carpiniello, B.
Affiliations: University of Cagliari (IT)
ORCID: Murru, Andrea
Carpiniello, Bernardo
Venue: Neuroscience Letters
Publisher: Elsevier BV
Published: 2018-03
Volume: 669
Pages: 59-67
ISSN: 0304-3940 (ISSN-L)
DOI: 10.1016/j.neulet.2016.10.003
OpenAlex: W2529050961
Cited by: 135
References: 126
Citations by year: 2026: 7 · 2025: 15 · 2024: 15 · 2023: 16 · 2022: 18 · 2021: 16 · 2020: 17 · 2019: 17 · 2018: 7 · 2017: 6
FWCI: 1.42
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Neuroscience Letters (publishedVersion)
PubMed (publishedVersion)
Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, cc-by-nc-nd)
UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords: duration of untreated psychosis, schizophrenia, first-episode psychosis, early intervention, treatment outcomes, negative symptoms, functional outcome, neuroimaging correlates, cognitive impairment, access to mental health care, secondary prevention
MeSH terms: Humans, Prognosis, Psychotic Disorders, Schizophrenia, Early Diagnosis, Early Medical Intervention, Time-to-Treatment

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Duration of untreated illness as a key to early intervention in schizophrenia: a review.

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