Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-18T16:55:46.142Z Has data issue: false hasContentIssue false
  • English
  • Français

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
...Show all authors
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).
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

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

References

Andreasen, N.C.Flaum, M.C.Arndt, S.. The Comprehensive Assessment of Symptoms and History (CASH): An instrument for assessing diagnosis and psychopathology. Arch Gen Psychiatry 1992;49:615–623.CrossRefGoogle ScholarPubMed
Association. AP. Diagnostic and statistical manual disorders, 4th edn 1994.Google Scholar
Birchwood, M.Connor, C.Lester, H.Patterson, P.Freemantle, N.Marshall, M., et al.Reducing duration of untreated psychosis: Care pathways to early intervention in psychosis services. Br J Psychiatry. 2013;203:58–64.CrossRefGoogle ScholarPubMed
Birchwood, M.Smith, J.Cochrane, R.Wetton, S.Copestake, S.. The Social Functioning Scale: The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. Br J Psychiatry. 1990;157:853–859.CrossRefGoogle ScholarPubMed
Chang, W.C.Hui, C.L.Tang, J.Y.Wong, G.H.Chan, S.K.Lee, E.H., et al.Impacts of duration of untreated psychosis on cognition and negative symptoms in first-episode schizophrenia: a 3-year prospective follow-up study. Psychol Med. 2013;43:1883–1893.CrossRefGoogle ScholarPubMed
Cuesta, M.J.Garcia de Jalon, E.Campos, M.S.Ibanez, B.Sanchez-Torres, A.M.Peralta, V.. Duration of untreated negative and positive symptoms of psychosis and cognitive impairment in first episode psychosis. Schizophr Res. 2012;141:222–227.CrossRefGoogle ScholarPubMed
Farooq, S.Large, M.Nielssen, O.Waheed, W.. The relationship between the duration of untreated psychosis and outcome in low-and-middle income countries: a systematic review and meta analysis. Schizophr Res. 2009;109:15–23.CrossRefGoogle ScholarPubMed
Goldberg, T.E.Burdick, K.E.McCormack, J.Napolitano, B.Patel, R.C.Sevy, S.M., et al.Lack of an inverse relationship between duration of untreated psychosis and cognitive function in first episode schizophrenia. Schizophr Res. 2009;107:262–266.CrossRefGoogle ScholarPubMed
Green, M.F.Kern, R.S.Braff, D.L.Mintz, J.. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”?. Schizophr Bull. 2000;26:119–136.CrossRefGoogle ScholarPubMed
Green, M.F.Kern, R.S.Heaton, R.K.. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res. 2004;72:41–51.CrossRefGoogle ScholarPubMed
Guy, W.Early clinical drug evaluation unit (ECDEU) assessment manual for psychopharmacology. Rockville, Md: National Institute of Health; 1976.Google Scholar
Harrison, G.Croudace, T.Mason, P.Glazebrook, C.Medley, I.. Predicting the long-term outcome of schizophrenia. Psychol Med. 1996;26:697–705.CrossRefGoogle ScholarPubMed
Ito, S.Hasegawa, T.Matsumoto, K.Tsujino, N.Tohgi, N.Mizuno, M.. Evaluating the Duration of Untreated Psychosis Using Medical Records. Seishin Igaku. 2011;53:559–562. [Japanese].Google Scholar
Jablensky, A.Sartorius, N.Ernberg, G.Anker, M.Korten, A.Cooper, J.E., et al.Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl. 1992;20:1–97.CrossRefGoogle ScholarPubMed
Kaneda, Y.Kamioka, Y.Sumiyoshi, T.Furukori, N.Ito, T.Higuchi, Y., et al.The Schizophrenia Cognition Rating Scale Japanese Version (SCoRS-J). Seishin Igaku. 2010;52:1027–1030 [Japanese].Google Scholar
Kay, S.R.Fiszbein, A.Opler, L.A.. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13:261–276.CrossRefGoogle Scholar
Keefe, R.S.Poe, M.Walker, T.M.Kang, J.W.Harvey, P.D.. The Schizophrenia Cognition Rating Scale: an interview-based assessment and its relationship to cognition, real-world functioning, and functional capacity. Am J. Psychiatry. 2006;163:426–432.CrossRefGoogle ScholarPubMed
Lincoln, C.V.McGorry, P.. Who cares? Pathways to psychiatric care for young people experiencing a first episode of psychosis. Psychiatr Serv. 1995;46:1166–1171.Google ScholarPubMed
Marshall, M.Lewis, S.Lockwood, A.Drake, R.Jones, P.Croudace, T.. Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry. 2005;62:975–983.CrossRefGoogle ScholarPubMed
Matsuoka, K.Uno, M.Kasai, K.Koyama, K.Kim, Y.. Estimation of premorbid IQ in individuals with Alzheimer's disease using Japanese ideographic script (Kanji) compound words: Japanese version of National Adult Reading Test. Psychiatry Clin Neurosci. 2006;60:332–339.CrossRefGoogle ScholarPubMed
Morgan, C.Abdul-Al, R.Lappin, J.M.Jones, P.Fearon, P.Leese, M., et al.Clinical and social determinants of duration of untreated psychosis in the AESOP first-episode psychosis study. Br J Psychiatry 2006;189:446–452.CrossRefGoogle ScholarPubMed
Nelson, H.E.National Adult Reading Test (NART): For the Assessment of Premorbid Intelligence in Patients with Dementia: Test Manual. Windsor, UK: NFER-Nelson; 1982.Google Scholar
Nemoto, T.Fujii, C.Miura, Y.Chino, B.Kobayashi, H.Yamazawa, R., et al.Reliability and validity of the social functioning scale Japanese version (SFS-J). Jpn Bull Soc Psychiatry 2008;17:188–195 [Japanese].Google Scholar
Nishii, H.Yamazawa, R.Shimodera, S.Suzuki, M.Hasegawa, T.Mizuno, M.. Clinical and social determinants of a longer duration of untreated psychosis of schizophrenia in a Japanese population. Early Interv Psychiatry. 2010;4:182–188.CrossRefGoogle Scholar
Okazaki, Y.Kitamura, T.Anzai, N.CASH. Tokyo: Seiwa Shoten; 1994 [Japanese].Google Scholar
Organization, W.H.Personal and Psychiatric History Schedule. Geneva: WHO; 1996.Google Scholar
Perkins, D.O.Gu, H.Boteva, K.Lieberman, J.A.. Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry. 2005;162:1785–1804.CrossRefGoogle ScholarPubMed
Rapp, C.Studerus, E.Bugra, H.Aston, J.Tamagni, C.Walter, A., et al.Duration of untreated psychosis and cognitive functioning. Schizophr Res. 2013;145:43–49.CrossRefGoogle ScholarPubMed
Tasaki, M.Nakane, M.WHOQOL manual [WHOQOL-no-tebiki]. Tokyo: Kaneko-Shobo; 1997 [Japanese].Google Scholar
Verdoux, H.Liraud, F.Bergey, C.Assens, F.Abalan, F.van Os, J.. Is the association between duration of untreated psychosis and outcome confounded?. A two year follow-up study of first-admitted patients. Schizophr Res. 2001;49:231–241.CrossRefGoogle ScholarPubMed
Yamada, H.Masui, K.Kikumoto, K.Positive and Negative Syndrome Scale (PANSS) rating manual. Tokyo: Seiwa Shoten; 1991 [Japanese].Google Scholar
Yamazawa, R.Mizuno, M.Nemoto, T.Miura, Y.Murakami, M.Kashima, H.Duration of untreated psychosis and pathways to psychiatric services in first-episode schizophrenia. Psychiatry Clin Neurosci. 2004;58:76–81.CrossRefGoogle ScholarPubMed
Yamazawa, R.Nemoto, T.Kobayashi, H.Chino, B.Kashima, H.Mizuno, M.Association between duration of untreated psychosis, premorbid functioning, and cognitive performance and the outcome of first-episode schizophrenia in Japanese patients: prospective study. Aust N Z J Psychiatry 2008;42:159–165.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.