Article metrics

  • citations in SCindeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[=>]
  • visits in previous 30 days:41
  • full-text downloads in 30 days:41
article: 8 from 152  
Back back to result list
2010, vol. 32, iss. 4, pp. 35-44
article language: Serbian
document type: Original Scientific Paper
published on: 10/11/2010
Duration of untreated psychosis: The definition, the description and relation to the illness outcome
aClinical Centre 'Zvezdara', Belgrade
bClinical Center of Serbia, Clinic for Psychiatry, Belgrade + University of Belgrade, Faculty of Medicine



The concept of duration of untreated psychosis (DUP) attracted much interest during the last decade because of its possible relationship to treatment outcome and implications for prevention of psychotic disorders, especially schizophrenia. In this paper we explain the components of DUP and review methodological problems of DUP assessment. Additionally, we summarize the literature concerning the concept and its importance. Evidence suggests that duration of untreated psychosis may be related to ease of reducing psychotic symptoms once treatment begins for first episode patients, and there is some evidence of a relationship to likelihood of relapse. Also, investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning were shown. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention. Assessment of DUP in our surrounding is strongly recommended as an essential component of early psychosis programs.


duration of untreated psychosis; schizophrenia; early intervention; methodology


American Psychiatric Association (1987) Diagnostic and Statistical Manual for Mental Disorders. Washington, DC
Beiser, M., Erickson, D., Fleming, J.A., Iacono, W.G. (1993) Establishing the onset of psychotic illness. Am J Psychiatry, 150(9): 1349-54
Bertolote, J., Mcgorry, P. (2005) Early interventions and recovery for young people with early psychosis: Consensus statement. Br J Psychiatry, 187(48): s116-9
Brunet, K., Birchwood, M., Lester, H., Iqbal, Z., Thornhill, K., Coles, S. (2006) Treatment delay and pathways to care in early psychosis: The trouble with ambiguous cases. Schizophr Res, 86:S40
Brunet, K.F., Birchwood, M., Lester, H., Thornhill, K. (2007) Delays in mental health services and duration of untreated psychosis. Psychiatric Bulletin, 31(11): 408
Cole, E., Leavey, G., King, M., Johnson-Sabine, E., Hoar, A. (1995) Pathways to care for patients with a first episode of psychosis A comparison of ethnic groups. British journal of psychiatry : the journal of mental science, 167(6): 770-6
Compton, M., Goulding, S., Ramsay, C., Addington, J., Corcoran, C., Walker, E. (2008) Early detection and intervention for psychosis: Perspectives from north America. J Clin Psychiatry, 5(6), str. 263-72
Fendri, C., Mechri, A., Khiari, G., Othman, A., Kerkeni, A., Gaha, L. (2006) Oxidative stress involvement in schizophrenia pathophysiology: A review. Encephale, 32(2 Pt 1), str. 244-52
Franz, L., Carter, T., Leiner, A.S., Bergner, E., Thompson, N.J., Compton, M.T. (2010) Stigma and treatment delay in first-episode psychosis: a grounded theory study. Early intervention in psychiatry, 4(1): 47-56
Gater, R., Jordanova, V., Maric, N., Alikaj, V., Bajs, M., Cavic, T., Dimitrov, H., Iosub, D., Mihai, A., Szalontay, A.S., Helmchen, H., Sartorius, N. (2005) Pathways to psychiatric care in Eastern Europe. British journal of psychiatry, 186: 529-35
Hafner, H., Riecher-Rossler, A., Hambrecht, M., Maurer, K., Meissner, S., Schmidtke, A., Fatkenheuer, B., Loffler, W., van der Heiden, W. (1992) IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophrenia research, 6(3): 209-23
Jindal, R.D., Keshavan, M.S. (2008) Neurobiology of the early course of schizophrenia. Expert review of neurotherapeutics, 8(7): 1093-100
Johannessen, J.O., Larsen, T., Joa, I., Melle, I., i dr. (2005) Pathways to care for first-episode psychosis in an early detection healhcare sector. Part of the Scandinavian TIPS study. British Journal of Psychiatry, 187(48): s24
Judge, A.M., Estroff, S.E., Perkins, D.O., Penn, D.L. (2008) Recognizing and responding to early psychosis: a qualitative analysis of individual narratives. Psychiatric services (Washington, D.C.), 59(1): 96-9
Keshavan, M.S., Berger, G., Zipursky, R.B., Wood, S.J., Pantelis, C. (2005) Neurobiology of early psychosis. Br J Psychiatry Suppl, 48: s8-18
Koenen, K.C., Moffitt, T.E., Roberts, A.L., Martin, L.T., Kubzansky, L., Harrington, H., Poulton, R., Caspi, A. (2009) Childhood IQ and adult mental disorders: a test of the cognitive reserve hypothesis. American journal of psychiatry, 166(1): 50-7
Larsen, T.K., Johannessen, J.O., Opjordsmoen, S. (1998) First-episode schizophrenia with long duration of untreated psychosis Pathways to care. British journal of psychiatry. Supplement, 172(33): 45-52
Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., Croudace, T. (2005) Association between duration of untreated psychosis and in cohorts of first-episode outcome patients: A systematic review. Archives of General Psychiatry, 62(9): 975
Mcglashan, T., Joa, I., Larsen, T.K., i dr. (2007) Educational information campaigns are critical to reducing duration of untreated psychosis. Schizophr Bull, 33: 486
Mcglashan, T.H. (2006) Is active psychosis neurotoxic?. Schizophrenia bulletin, 32(4): 609-13
McGlashan, T.H. (1999) Duration of untreated psychosis in first-episode schizophrenia: Marker or determinant of course?. Biol Psychiatry, 46(7): 899-907
Mcglashan, T.H., Hoffman, R.E. (2000) Schizophrenia as a disorder of developmentally reduced synaptic connectivity. Arch Gen Psychiatry, 57(7): 637-48
Mcgorry, P.D., Mcfarlane, C., Patton, G.C., Bell, R., Hibbert, M.E., Jackson, H.J., Bowes, G. (1995) The prevalence of prodromal features of schizophrenia in adolescence: A preliminary survey. Acta psychiatrica Scandinavica, 92(4): 241-9
Melle, I., Larsen, T.K., Haahr, U., Friis, S., Johannessen, J.O., Opjordsmoen, S., Simonsen, E., Rund, B.R., Vaglum, P., McGlashan, T. (2004) Reducing the duration of untreated first-episode psychosis: Effects on clinical presentation. Archives of general psychiatry, 61(2): 143-50
Morgan, C., Abdul-Al, R., Lappin, J.M., Jones, P., Fearon, P., Leese, M., Croudace, T., Morgan, K., Dazzan, P., Craig, T., Leff, J., Murray, R. (2006) Clinical and social determinants of duration of untreated psychosis in the AESOP first-episode psychosis study. British journal of psychiatry, 189: 446-52
Norman, R.M., Malla, A.K. (2001) Duration of untreated psychosis: A critical examination of the concept and its importance. Psychological medicine, 31(3): 381-400
Pantelis, C., Yücel, M., Wood, S.J., McGorry, P.D., Velakoulis, D. (2003) Early and late neurodevelopmental disturbances in schizophrenia and their functional consequences. Australian and New Zealand journal of psychiatry, 37(4): 399-406
Perkins, D.O., Leserman, J., Jarskog, L.F., Graham, K., Kazmer, J., Lieberman, J.A. (2000) Characterizing and dating the onset of symptoms in psychotic illness: The Symptom Onset in Schizophrenia (SOS) inventory. Schizophrenia research, 44(1): 1-10
Perkins, D.O., Gu, H., Boteva, K., Lieberman, J.A. (2005) Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: A critical review and meta-analysis. American journal of psychiatry, 162(10): 1785-804
Power, P., Iacoponi, E., Reynolds, N., i dr. (2007) The Lambeth early onset crisis assessment team study: General practitioner education and access to an early detection team in first-episode psychosis. British Journal of Psychiatry, 191(51): s133
Riecher-Rössler, A., Gschwandtner, U., Aston, J., Borgwardt, S., Drewe, M., Fuhr, P., Pflüger, M., Radü, W., Schindler, C., Stieglitz, R.D. (2007) The Basel early-detection-of-psychosis (FEPSY)-study: Design and preliminary results. Acta psychiatrica Scandinavica, 115(2): 114-25
Rund, B.R. (2009) Is schizophrenia a neurodegenerative disorder?. Nordic journal of psychiatry, 63(3): 196-201
Singh, S.P., Cooper, J.E., Fisher, H.L., Tarrant, J.C., Lloyd, T., Banjo, J., Corfe, S., Jones, P. (2005) Determining the chronology and components of psychosis onset: The Nottingham Onset Schedule (NOS). Schizophrenia research, 80(1): 117-30
Thompson, P.M., Vidal, C., Giedd, J.N., Gochman, P., Blumenthal, J., Nicolson, R., Toga, A.W., Rapoport, J.L. (2001) Mapping adolescent brain change reveals dynamic wave of accelerated gray matter loss in very early-onset schizophrenia. Proc Natl Acad Sci USA, 98(20): 11650-5
Verdoux, H., Bergey, C., Assens, F., Abalan, F., Gonzales, B., Pauillac, P., Fournet, O., Liraud, F., Beaussier, J., Gaussares, C., Etchegaray, B., Bourgeois, M., Os, J. (1998) Prediction of duration of psychosis before first admission. European psychiatry, 13(7): 346-52