What are the physical and mental health implications of duration of untreated psychosis?

Abstract

Psychotic disorders, such as schizophrenia, are among the most severe and debilitating conditions in psychiatry, and in all of medicine. Duration of untreated psychosis (DUP) is the period that goes from the onset of psychosis to the start of an adequate treatment. DUP is an important prognostic factor, as longer DUP has been associated with poor mental health outcomes, including more severe positive and negative symptoms and decreased likelihood of remission. However, DUP has been a source of controversy lately, particularly regarding its relationship with psychosocial functioning, arguably one of the most important mental health outcomes for psychiatric patients along with quality of life. In this discussion about the relevance and effects of DUP, several factors have clinical and practical importance. Most studies supporting either the first or the second scenario are observational, which limits inferences on causation. In conclusion, although we believe the hypothesis of LTB confounding the association between DUP and poor outcomes merits further study, clinicians must ensure that prevention and early intervention targeting both mental and physical health remain at the frontline of their efforts when treating patients with psychotic disorders. (PsycInfo Database Record (c) 2022 APA, all rights reserved)