ABSTRACT
OBJECTIVE: This study examines 1year outcome in patients having first-episode non-affective psychosis, with emphasis on Duration of Untreated Psychosis (DUP) and premorbid functioning, in order to clarify how these factors interact. METHOD: Forty-three consecutively admitted patients were all rated on the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF), both upon hospitalization and at 1year follow-up. In addition, premorbid functioning, DUP, duration of hospitalization, and social functioning were rated. RESULTS: Fifty-six per cent were in remission, 18% suffered multiple relapses and 26% were continuously psychotic at 1 year follow-up. Both poor premorbid functioning and long DUP are significantly correlated with more negative symptoms and poorer global functioning at follow-up. Long DUP is also significantly correlated with more positive symptoms. Even when we control for other factors, including premorbid functioning and gender, DUP is a strong predictor of outcome. To a limited degree premorbid functioning and DUP interact, but DUP has an independent influence on outcome. CONCLUSIONS: these findings strengthen the rationale for establishing health service programs for early detection and treatment of first-onset psychosis
Subject(s)
Psychotic Disorders/diagnosis , Adolescent , Adult , Female , Follow-Up Studies , Hospitalization , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Psychotic Disorders/etiology , Psychotic Disorders/rehabilitation , Regression Analysis , Remission, Spontaneous , Schizophrenia/complications , Schizophrenia/diagnosis , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
This article describes the application of the Premorbid Adjustment Scale to Norwegian subjects with first-episode schizophrenia. The scale measures premorbid functioning from several perspectives: functioning at different developmental periods, change of functioning over time, and distinctive patterns of functioning over time. Gender differences were striking, with males scoring poorer and deteriorating faster than females, especially closer to onset. While the duration of untreated psychosis (DUP) was significantly longer in males, correlations between DUP and premorbid functioning within gender were largely nonsignificant, as were the analyses of premorbid functioning and age at onset. On the other hand, we replicated studies that found associations between poorer premorbid functioning and insidious onset and negative symptoms. Overall, our premorbid patterns suggest that a process of asymptomatic premorbid deficit formation precedes onset by some period, especially among males. The patterns also suggest that active symptom formation does not always precede this deteriorative process.