Duration of Untreated Psychosis and Clinical Outcome 1 Year after First-Episode Psychosis
Bibliographic record
Abstract
Abstract Objective: The effectiveness of early intervention for patients with first-episode psychosis is uncertain. This study aimed to explore the association of duration of untreated psychosis and short-term clinical outcome. Patients and Methods: Ninety four patients receiving treatment from an early intervention programme in Hong Kong (the Early Assessment Service for Young People with First-episode Psychosis) were retrospectively assessed using a standardised survey to examine the relationship between duration of untreated psychosis and 1-year outcome variables such as treatment adherence, time to treatment response, and academic and occupational functioning. Results: Patients with a shorter duration of untreated psychosis had better treatment adherence and responded to treatment more quickly than patients with a longer duration of untreated psychosis. However, patients with a shorter duration of untreated psychosis were more likely to be admitted to hospital during their first psychotic episode. Duration of untreated psychosis was not related to the level of occupational functioning and the risk for relapse after stabilisation of first-episode psychosis. Conclusions: These findings suggest that patients with a shorter duration of untreated psychosis tend to present more acutely, yet have a faster rate of recovery, than patients with a longer duration of untreated psychosis. Duration of untreated psychosis has a significant effect on treatment adherence in the initial recovery phase. However, further studies are required to evaluate the relationship between duration of untreated psychosis and long-term outcome, as well as the impact of duration of untreated psychosis on the subsequent utilisation of health services. Key words: Hong Kong, Psychotic disorders, Treatment outcome Introduction Patients with psychosis tend to present for medical treatment a substantial time after the onset of symptoms. This delay may be influenced by a number of factors, some of which cannot be altered (e.g., a patient's sex) and some of which can. Studies have demonstrated that a delay to initial treatment of first-episode psychosis (FEP) plays a critical role in influencing the outcome of psychotic disorders. (1-9) This period of delay is referred to as the duration of untreated psychosis (DUP) and is usually extremely long. Studies from the USA, Canada, and Europe have consistently reported a mean DUP of 1 to 2 years. (10) Several studies (1-4,6-8) have shown a significant relationship between DUP and several domains of outcome, while others (5,11) have failed to demonstrate this, especially when addressing long-term outcomes. One study reported that 83.7% of patients with a short DUP ( The extent to which DUP affects the outcome of patients with psychosis remains controversial. This study contributes to the debate by examining whether a relationship exists between DUP and treatment outcome for patients with FEP in Hong Kong. This study evaluated patients with FEP who presented to the Early Assessment Service for Young People with First-episode Psychosis (EASY) programme in Hong Kong, and determined whether DUP is related to outcomes such as relapse rates and treatment adherence. Patients and Methods Patients The study recruited patients with psychotic disorders who had received the initial diagnosis more than 1 year previously. The study period ranged from 1 July 2001 to 31 December 2002. Patients who defaulted follow-up were also included, as non-engagement was a possible outcome. …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".