Shorter DUP linked to better long-term schizophrenia outcomes

By Mark Cowen, Senior MedWire Reporter

A shorter duration of untreated psychosis (DUP) is associated with improved long-term outcomes in patients with schizophrenia, researchers report.

Bernardo Carpiniello (University of Cagliari, Italy) and colleagues found that a shorter DUP was significantly associated with a more favorable course of illness, reduced hospitalization rates, and better overall functioning in schizophrenia patients over a follow-up period of up to 33 years.

"The data presented here give further support to the hypothesis whereby early intervention, associated with an appreciable effect on the fate of patients, is capable of altering the prognosis of schizophrenia even in the long term," comment the authors.

The researchers examined the clinical charts of 80 outpatients (52 men) with schizophrenia, who were aged a mean of 51 years, to assess associations between DUP and various long-term outcome measures. A favorable course of illness was defined as being episodic without intercritical residual symptoms, experiencing a single episode and being in partial remission, or experiencing a single episode and being in full remission.

Overall, the mean duration of follow up was 25.2 years and the mean DUP among the patients was 49 months.

Analysis revealed that patients with a DUP of less than 1 year were more likely to have a favourable course of illness than those with a longer DUP, at 28.9% versus 8.6%.

Furthermore, patients with a DUP of less than 1 year were more likely than those with a longer DUP to have been hospitalized less than three times, at 85.7% versus 62.1%, and to have better Global Assessment of Functioning scores, at 50.32 versus 40.26.

However, there was no significant difference between patients with a short and long DUP regarding mean number of suicide attempts.

The researchers note that previous studies have shown that a reduced DUP is associated with improved short-term outcomes in schizophrenia patients.

"A shorter DUP appears to act as a significant predictor of better outcome in schizophrenia even in the very long-term," they conclude in the Annals of General Psychiatry.

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