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

Schizophr Res. 2000 Sep 29;45(1-2):1-9. doi: 10.1016/s0920-9964(99)00169-3.


Objective: This study examines 1year 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 1year 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

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / etiology
  • Psychotic Disorders / rehabilitation
  • Regression Analysis
  • Remission, Spontaneous
  • Schizophrenia / complications
  • Schizophrenia / diagnosis
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome