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Untreated illness and recovery in clients of an early psychosis intervention program: a 10-year prospective cohort study

Abstract

Purpose

To investigate whether duration of untreated psychosis (DUP) and duration of untreated illness (DUI) are associated with measures of both subjective and objective recovery 10 years after a first episode of psychosis.

Methods

A cohort of 65 clients from an early psychosis intervention program completed a battery of outcome measures 10 years following initial treatment for first-episode psychosis (FEP). The outcomes of interest were self-perceived recovery scores (Maryland Assessment of Recovery in People with Serious Mental Illness Scale) and occupational activity, defined as engagement in work and/or school on a full/part-time basis. Multiple linear and logistic regression analyses were used to estimate the associations between DUP and DUI with each measure of recovery, adjusting for potential confounding factors.

Results

We did not find a statistically significant association between DUP and either occupational activity (OR = 1.26, 95% CI 0.81–1.95) or self-perceived recovery score (β = − 0.73, 95% CI − 2.42 to 0.97). However, we found a significant negative association between DUI and self-perceived recovery score (β = − 0.52, 95% CI − 0.87 to − 0.16).

Conclusions

Our findings suggest that DUI may have a stronger influence than DUP on recovery from FEP at 10-year follow-up. This suggests the potential value in targeted interventions for people with a long DUI to increase the likelihood of achieving recovery after the first episode of psychosis.

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Correspondence to Kelly K. Anderson.

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Ethical standard

All participants provided informed consent prior to their inclusion in this study, and ethics approval was granted by the Health Sciences Research Ethics Board at The University of Western Ontario. Therefore, this study “has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its amendments.” Furthermore, no details have been published that may disclose the identity of the participants in this study.

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The authors declare that they have no conflict of interest.

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Bhullar, G., Norman, R.M.G., Klar, N. et al. Untreated illness and recovery in clients of an early psychosis intervention program: a 10-year prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 53, 171–182 (2018). https://doi.org/10.1007/s00127-017-1464-z

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Keywords

  • First-episode psychosis
  • Duration of untreated psychosis
  • Duration of untreated illness
  • Recovery
  • Early intervention
  • Prospective