Relationship between duration of untreated prodromal symptoms and symptomatic and functional recovery
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Our previous study has found that a long duration of untreated prodromal symptoms (DUPrS) does not increase the conversion risk to psychosis in individuals with attenuated psychosis syndrome (APS). However, whether a long DUPrS will lead to other poor outcomes remains unknown. The purpose of this study was to analyse the association between the DUPrS and outcomes (symptomatic and functional recovery) in APS population. A post hoc analysis was performed in 391 individuals with APS as identified by the structured interview. APS subjects had follow-up interviews every 6 months for 2 years following diagnosis. Poor functional outcome was defined as a Global Assessment of Functioning (GAF) score less than 60 at the time of follow-up. Poor symptomatic outcome was defined as at least one of the positive symptoms rated scores of 3 or higher. A post hoc analysis was performed in 391 individuals with APS as identified by the structured interview. APS subjects had follow-up interviews every 6 months for 2 years following diagnosis. Poor functional outcome was defined as a Global Assessment of Functioning (GAF) score less than 60 at the time of follow-up. Poor symptomatic outcome was defined as at least one of the positive symptoms rated scores of 3 or higher. Of total 391 individuals, 334 were followed up for 2 years to assess clinical outcome, 82 (24.6%) had shown conversion to psychosis, 79 (23.7%) met the criteria of poor functioning outcome, and 145 (43.4%) met the criteria of poor symptomatic outcome. A significant correlation between GAF scores and DUPrS was observed in the non-converter group, but not in the converters. Individuals with APS who had a longer DUPrS were correlated with poorer functional outcome. However, it was not correlated with poorer symptomatic outcome. While a longer DUPrS was not related to poor symptomatic outcome, it was significantly related to poor functional outcome. Our findings highlight the importance of reducing DUPrS to decrease future functional impairment in populations at risk for psychosis.
KeywordsDuration of untreated psychosis Duration of untreated prodromal symptoms Prodromal psychosis Clinical high risk Outcome
This study was supported by Ministry of Science and Technology of China, National Key R&D Program of China (2016YFC1306803), National Natural Science Foundation of China (81671329, 81671332), Shanghai Key Laboratory of Psychotic Disorders (13dz2260500), Clinical Research Plan of SHDC (16CR2015A, 16CR3016A), Shanghai Mental Health Center Foundation (2016-FX-01), and Program of Shanghai Academic Research Leader (16XD1402400). For memorial purpose, Dr. Larry J. Seidman passed away on September 7, 2017. Dr. Robert W. McCarley passed away on May 27, 2017. Both were founders and core members of the SHARP (ShangHai At Risk for Psychosis) project.
Compliance with ethical standards
Conflict of interest
None of the authors had a conflict of interest.
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