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Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset

Published online by Cambridge University Press:  24 October 2015

S. Ito ,
T. Nemoto ,
N. Tsujino ,
N. Ohmuro ,
K. Matsumoto ,
H. Matsuoka ,
K. Tanaka ,
S. Nishiyama ,
M. Suzuki  and
H. Kinoshita
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S. Ito
Affiliation:
Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan
T. Nemoto*
Affiliation:
Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
N. Tsujino
Affiliation:
Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
N. Ohmuro
Affiliation:
Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
K. Matsumoto
Affiliation:
Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
H. Matsuoka
Affiliation:
Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
K. Tanaka
Affiliation:
Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
S. Nishiyama
Affiliation:
Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
M. Suzuki
Affiliation:
Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
H. Kinoshita
Affiliation:
Department of Neuropsychiatry, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
H. Ozawa
Affiliation:
Department of Neuropsychiatry, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
H. Fujita
Affiliation:
Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
S. Shimodera
Affiliation:
Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
T. Kishimoto
Affiliation:
Department of Psychiatry, Nara Medical University, Nara, Japan
K. Matsumoto
Affiliation:
Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan
T. Hasegawa
Affiliation:
Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan
M. Mizuno
Affiliation:
Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
*
⁎Corresponding author. Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, 143-8541, Tokyo, Japan. Tel.: +81 3 3762 4151; fax: +81 3 5471 5774. E-mail address:[email protected] (T. Nemoto).
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Abstract

Background

The mode of onset and the course of schizophrenia illness exhibit substantial individual variations. Previous studies have pointed out that the mode of onset affects the duration of untreated psychosis (DUP) and clinical outcomes, such as cognitive and social functioning. This study attempted to clarify the association between the DUP and clinical features, taking the different modes of onset into consideration, in a prospective longitudinal study examining patients with first-episode schizophrenia.

Methods

This study was conducted in six areas of Japan. Patients with first-episode schizophrenia were followed for over 18 months. Cognitive function, psychopathology, and social functioning were assessed at baseline and at 6, 12, and 18-month follow-up points.

Results

We identified 168 patients and sufficient information was available to determine the DUP and the mode of onset for 156 patients (92.9%): 79 had an acute onset, and 77 had an insidious onset. The DUP was significantly associated with quality of life (QOL), social functioning, and cognitive function at most of the follow-up points in the insidious-onset group. The DUP and negative symptoms at baseline were significant predictors of cognitive function at the 18-month follow-up in the insidious-onset group.

Conclusions

The present results further support the hypothesis that the DUP affects QOL, social functioning, and cognitive function over the course of illness, especially in patients with an insidious onset. Effective strategies for detecting and caring for individuals with insidious onset early during the course of schizophrenia will be essential for achieving a full patient recovery.

Keywords

Cognitive functionDuration of untreated psychosis (DUP)First-episodeMode of onsetProspective follow-upSchizophrenia
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 8 , November 2015 , pp. 995 - 1001
Copyright
Copyright © European Psychiatric Association 2020

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Footnotes

1

Present address: Department of Public Health, Fukushima Medical University School of Medicine, Fukushima City, Japan.

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