Craig Morgan1, Rudwan Abdul-Al2, Julia Lappin1, Peter B. Jones2, Paul Fearon1, Morven Leese3, Tim Croudace2, Kevin Morgan4, Paola Dazzan4, Tom Craig4, Julian Leff4, Robin Murray4
1Division of Psychological Medicine, Institute of Psychiatry, London
2Department of Psychiatry, University of Cambridge
3Health Services Research Department, Institute of Psychiatry, London
4Division of Psychological Medicine, Institute of Psychiatry, London, UK
Tóm tắt
BackgroundDespite considerable research investigating the relationship between a
long duration of untreated psychosis (DUP) and outcomes, there has been
much less considering predictors of a long DUP.AimsTo investigate the clinical and social determinants of DUP in a large
sample of patients with a first episode of psychosis.MethodAll patients with a first episode of psychosis who made contact with
psychiatric services over a 2-year period and were living in defined
catchment areas in London and Nottingham, UK were included in the ÆSOP
study Data relating to clinical and social variables and to DUP were
collected from patients, relatives and case notes.ResultsAn insidious mode of onset was associated with a substantially longer DUP
compared with an acute onset, independent of other factors. Unemployment
had a similar, if less strong, effect. Conversely family involvement in
help-seeking was independently associated with a shorter duration. There
was weak evidence that durations were longer in London than in
Nottingham.ConclusionsThese findings suggest that DUP is influenced both by aspects of the
early clinical course and by the social context.
