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Soc Psychiatry Psychiatr Epidemiol. 2008 Dec;43(12):975-82. doi: 10.1007/s00127-008-0397-y. Epub 2008 Jul 5.

Mode of onset of psychosis and family involvement in help-seeking as determinants of duration of untreated psychosis.

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  • 1Dept. of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA. mcompto@emory.edu

Abstract

BACKGROUND:

The duration of untreated psychosis (DUP) is a potentially modifiable determinant of the early course of nonaffective psychotic disorders, though a paucity of research has addressed determinants of DUP. Recent data from London and Nottingham, UK indicated that a shorter DUP was predicted by: (1) an acute mode of onset, (2) employment, and (3) active involvement of at least one family member in seeking evaluation (Morgan et al. Br J Psychiatry 189:446-452, 2006). The present analysis was conducted in an effort to replicate those findings in a predominantly low-income, urban, African American sample.

METHOD:

DUP and the three key predictors of interest were assessed using standardized procedures. All analytic plans replicated those of Morgan and colleagues (Morgan et al. Br J Psychiatry 189:446-452, 2006) to the largest extent possible. Sufficient information was available to rate DUP for 73 patients.

RESULTS:

The median DUP was 23.4 weeks. Bivariate tests, survival analysis, and Cox regression revealed that an insidious mode of onset was associated with a substantially longer DUP compared with an acute onset, and that family involvement in help-seeking was independently associated with a longer duration.

CONCLUSIONS:

While mode of onset is a reliable illness-related determinant of DUP, further research is needed on the complex ways in which family-related variables influence DUP.

PMID:
18604616
DOI:
10.1007/s00127-008-0397-y
[PubMed - indexed for MEDLINE]
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