Duration of Active Psychosis and First-Episode Psychosis Negative Symptoms

Early Interv Psychiatry. 2017 Feb;11(1):63-71. doi: 10.1111/eip.12217. Epub 2015 Jan 13.

Abstract

Aim: Duration of untreated psychosis (DUP) has been associated with negative symptoms in several studies; however, longitudinal findings have been inconsistent. No previous study has accounted for active psychosis after presentation, although this could impact on outcomes in a manner similar to DUP.

Methods: We measured Scale for the Assessment of Positive Symptoms at frequent intervals during the 12 months after initial presentation to determine the active psychosis duration for 230 individuals with first-episode psychosis. This duration was added to DUP prior to presentation to create a new variable, duration of active psychosis (DAP). Negative symptoms were divided into expressivity and motivation/pleasure domains as measured by Scale for the Assessment of Negative Symptoms (SANS). The relationship of DUP and DAP with negative symptoms at 24-month follow up was determined and confounders controlled for using regression analysis.

Results: When DUP and DAP were compared as binary variables with long and short groups, 25.2% of individuals had differing category membership. DAP had a significant uncorrected association with both expressivity domain and motivation/pleasure domains at 24 months; however, relationship with DUP was not significant. DAP remained a significant predictor of 24-month expressivity domain after controlling for potential confounders.

Conclusions: Active psychosis after presentation is substantial, which is a limitation of DUP studies if active psychosis is considered as the key factor within DUP. DAP is a better predictor of negative symptoms than DUP at 2-year follow up, which suggests this concept requires further research.

Keywords: active psychosis; duration of untreated psychosis; first-episode psychosis; negative symptom; schizophrenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / psychology
  • Bipolar Disorder / therapy
  • Chronic Disease
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Motivation
  • Pleasure
  • Prodromal Symptoms
  • Psychiatric Status Rating Scales / statistics & numerical data*
  • Psychometrics*
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / therapy
  • Quebec
  • Schizophrenia / diagnosis*
  • Schizophrenia / therapy
  • Schizophrenic Psychology*
  • Social Adjustment
  • Time Factors
  • Young Adult

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