Conceptualizing the Multifaceted Determinants of the Duration of Untreated Psychosis

Abstract

The duration of untreated psychosis (DUP) construct is recognized as a predictor of early-course outcomes of individuals diagnosed with nonaffective psychotic disorders. Although a major area of early-psychosis research has been DUP as a predictor of outcomes, less is known about the potential determinants of DUP. Because the community-level median DUP may be modifiable, which is compelling evidence for the promotion of the early intervention paradigm, knowledge of determinants of DUP is critical. This review summarizes what is known of the multifaceted determinants of DUP. In general, these complex determinants can be categorized as demographic factors (e.g., ethnic minority status), premorbid and onset-related factors (such as mode of onset of psychosis), illness-related factors (exemplified by the levels of positive and negative symptoms), family-level factors (including family involvement in help-seeking and family functioning), societal factors (e.g., the beliefs and practices of one's social networks), and health services/system-level factors (including health insurance status and the efficiency of referring clinicians). Despite the great complexity, efforts to understand and conceptualize the multifaceted determinants of DUP may inform key components of early detection and intervention programs, such as mobile early detection teams and community-level informational campaigns. © 2011 Bentham Science Publishers Ltd.