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Effects of duration of untreated psychosis on the clinical course and neurocognitive features of schizophrenia

Authors


Correspondence

Semra Ulusoy Kaymak MD, Psychiatry Clinic, Ankara Oncology Training and Research Hospital, Mahmut Esat Bozkurt Street No. 1, Kolej 06600, Ankara, Turkey.

Tel: +90 312 434 09 90/3043

Fax: +90 312 434 22 13

Email: semraulusoytr@yahoo.com

Abstract

Introduction

Prolonged duration of untreated psychosis (DUP) is one of the negative factors in the course of schizophrenia. The purpose of our study was to detect the long-term effects of DUP on the clinical and neurocognitive features of schizophrenia patients.

Methods

One hundred and sixty-two schizophrenia patients were divided into two groups (short and long-term DUP) according to the median duration (<6 months). The groups were then stratified according to duration of illness (DI) as short-term (≤10 years) and long-term. Psychopathology and clinical signs were evaluated by Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale (CGI) and Global Assessment of Functioning Scale (GAF). Executive functions were assessed using Frontal Assessment Battery (FAB), Colour Trail Test (CTT) and Wisconsin Card Sorting Test (WCST).

Results

Symptoms, cigarette consumption, treatment response, CGI, GAF, positive, negative and general subscales of the PANNS and FAB showed significant differences between the short- and long-term DUP groups. These differences were more significant in the long-term DI group. Positive correlation between DUP and age, cigarette consumption, length of illness, number of hospitalizations, resistance to treatment, compliance, and negative and total scores in PANNS were detected in the whole group of patients. However, the correlation of DUP with CGI and percentage of conceptual level response of WCST were negative.

Conclusion

Long-term DUP may have a negative effect on the clinical and neurocognitive features of schizophrenia. This effect more significantly appears in schizophrenia patients with longer DI.

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