Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-20T03:23:31.907Z Has data issue: false hasContentIssue false
  • English
  • Français

Toxic psychosis? Duration of untreated psychosis, symptomatology and cognitive deterioration in first episode psychosis

Published online by Cambridge University Press:  13 June 2014

Richard Lawoyin ,
Keith Gaynor ,
Barbara Dooley ,
Elizabeth Lawlor ,
Mary Clarke  and
Eadbhard O'Callaghan
Richard Lawoyin
Affiliation:
Cluain Mhuire Service, Blackrock, Co Dublin, Ireland
Keith Gaynor*
Affiliation:
Cluain Mhuire Service, Blackrock, Co Dublin University College Dublin, School of Psychology, Dublin 4, Ireland
Barbara Dooley
Affiliation:
University College Dublin, School of Psychology, Dublin 4, Ireland
Elizabeth Lawlor
Affiliation:
Cluain Mhuire Service, Blackrock, Co Dublin and DELTA/DETECT, Early Psychosis Intervention Project, Dun Laoghaire, Ireland
Mary Clarke
Affiliation:
St John of God Hospital, Stillorgan, Co Dublin, Ireland
Eadbhard O'Callaghan
Affiliation:
St John of God Hospital, Stillorgan, Co Dublin DELTA/DETECT, Early Psychosis Intervention Project, Dun Laoghaire and University College Dublin, School of Medicine, Dublin 4, Ireland
*
Correspondence Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: To examine the relationship between cognitive deficits, the duration of untreated psychosis (DUP) and positive and negative symptoms in a first episode psychosis sample.

Method: We assessed a consecutive sample of first episode psychosis participants from a catchment area service with a comprehensive neuropsychology battery, a family and service-user based measure of DUP and measures of symptomatology.

Results: Using correlations and stepwise linear regressions, we found strong relationships between measures of DUP and positive symptomatology. We found that positive and negative symptoms were associated with different time periods within DUP. However, we did not find evidence of a relationship between DUP and cognitive factors.

Conclusions: There was no evidence of a relationship between DUP and cognitive deterioration. However, there does appear to be evidence of a relationship between positive symptoms and aspects of DUP. These results highlight the importance of the heterogeneity of DUP and the potential to reduce positive symptoms through early intervention.

Keywords

PsychosisSchizophreniaDuration of untreated psychosisDUPCognitive functioning.
Type
Brief Report
Information
Irish Journal of Psychological Medicine , Volume 24 , Issue 4 , December 2007 , pp. 145 - 148
Copyright
Copyright © Cambridge University Press 2007

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.)

References

1.Norman, RMG, Malla, KA. Duration of untreated psychosis: a critical evaluation of the concept and its importance. Psychol Med 2001; 31: 381–400.CrossRefGoogle Scholar
2.Skeate, A, Jackson, C, Birchwood, M, Jones, C. Duration of untreated psychosis and pathways to care in first episode psychosis: investigation of help seeking behaviour in primary care. Br J Psychiatry (Suppl) 2002; 181(43): S73–S77.CrossRefGoogle Scholar
3.Browne, S, Clarke, M, Gervin, M, Waddington, JL, Larkin, C, O'Callaghan, E. Determinants of quality of life at first presentation with schizophrenia. Br J Psychiatry 2000;176:173–6.CrossRefGoogle ScholarPubMed
4.Harris, MGet al.The relationship between duration of untreated psychosis and outcome: an eight-year prospective study. Schizophr Res 2005; 79: 85–93.CrossRefGoogle ScholarPubMed
5.Keshavan, MS, Berger, G, Zipursky, RB, Wood, SJ, Pantelis, C. Neurobiology of early psychosis. Br J Psychiatry (Suppl) 2005; 187: S8–S18.CrossRefGoogle Scholar
6.Wyatt, R. Early intervention with neuroleptics may decrease the long-term morbidity of schizophrenia. Schizophr Res 1991; 5: 201–2.CrossRefGoogle ScholarPubMed
7.Harrop, CE, Trower, P. Why does schizophrenia develop at late adolescence? Chichester: Wiley, 2003.CrossRefGoogle Scholar
8.Heinrichs, RW, Zakzanis, KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 1998; 12: 426–45.CrossRefGoogle ScholarPubMed
9.Byrne, Met al.Neuropsychology, genetic liability and psychotic symptoms in those at high risk of schizophrenia. J Abnorm Psychol 2002; 112: 38–48.CrossRefGoogle Scholar
10.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th ed). Washington DC: American Psychiatric Association, 1994.Google Scholar
11.Beiser, M, Erickson, D, Fleming, JAE, Iacono, WG. Establishing the onset of psychotic illness. Am J Psychiatry 1993; 150: 1349–54.Google ScholarPubMed
12.Andreasen, NC. The scale for the assessment of positive symptoms (SAPS). Iowa City: University of Iowa, 1983b.Google Scholar
13.Andreasen, NC. The scale for the assessment of negative symptoms (SANS). Iowa City: University of Iowa, 1983a.Google Scholar
14.Malla, AK, Norman, RM, Manchada, R. Symptoms, cognition, treatment adherence and functional outcome in first-episode psychosis. Psychol Med 2002; 32: 1109–19.CrossRefGoogle ScholarPubMed
15.Thorup, Aet al.Integrated treatment ameliorates negative symptoms in first episode psychosis – results from the Danish OPUS trial. Schizophr Res 2005; 79: 95–105.CrossRefGoogle ScholarPubMed
16.Taylor, D, Patton, C, Kerwin, R. The South London and Maudsley NHS Trust Prescribing Guidelines (7th ed). Martin Dunitz: London, 2003.Google Scholar
17.ORYGEN Early Psychosis Service. First Episode Psychosis Survey Guidelines. Personal Communication. Melbourne, 2005Google Scholar
18.Wechsler, D. Wechsler Adult Intelligence Scale (3rd ed). New York: Psychological Corporation, 1997a.Google Scholar
19.Wechsler, D. Wechsler Test of Adult Reading. New York: Psychological Corporation, 2001.Google Scholar
20.Conners, CK. CPT: Connors' Continuous Performance Test. Toronto: Multi-Health Systems, 1995.Google Scholar
21.Spreen, O, Strauss, E. A compendium of neuropsychological tests: administration, norms and commentary. London: Oxford University Press, 1991.Google Scholar
22.Lezack, MD. Neuropsychological Assessment. New York: Oxford University Press, 1995.Google Scholar
23.Wilson, BA, Alderman, N, Burgess, PW, Emslie, H, Evans, JJ. Behavioural Assessment of the Dysexecutive Syndrome. St Edmunds, UK: Thames Valley Test Company, 1996.Google Scholar
24.Wechsler, D. The measurement and appraisal of adult intelligence. Baltimore: Williams and Wilkins Company, 1958.Google Scholar
25.Amminger, GP, Edwards, J, McGorry, PD. Estimating cognitive deterioration in schizophrenia. Br J Psychiatry 2002; 181: 164.CrossRefGoogle ScholarPubMed
26.Russsell, AJ, Munro, J, Jones, PB, Hayward, P, Hemsely, DR, Murray, RM. The National Adult Reading Test as a measure of premorbid IQ in schizophrenia. Br J Clin Psychol 2000; 39: 297–305CrossRefGoogle Scholar
27.Bilder, RM, Mukherjee, S, Rieder, RO, Pandurangi, AK. Symptomatic and neuropsychological components of defect states. Schizophr Bull 1985; 11: 409–19CrossRefGoogle ScholarPubMed
28.Norman, RMG, Townsend, L, Malla, AK. Duration of untreated psychosis and cognitive functioning in first episode patients. Br J Psychiatry 2001; 179: 340–5.CrossRefGoogle ScholarPubMed
29.Friss, Set al.Effects of an early detection program on duration of untreated psychosis: part of the Scandinavian TIPS study. Br J Psychiatry (Suppl) 2005; 48: S29–S32.CrossRefGoogle Scholar
30.Woodward, ND, Purdon, SE, Meitzer, HY, Zald, DH. A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharm 2005; 8: 457–72.CrossRefGoogle ScholarPubMed
31.Goldberg, TE, Weinberger, DR, Berman, KF, Pliskin, NH, Podd, MH. Further evidence for dementia of the prefrontal type in schizophrenia? A controlled study of teaching the Wisconsin Card Sorting Test. Arch Gen Psychiatry 1987; 44: 1008–14.CrossRefGoogle ScholarPubMed
32.Keefe, RS, Silva, SG, Perkins, DO, Lieberman, JA. The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis. Schizophr Bull 1999; 25: 201–22.CrossRefGoogle ScholarPubMed
33.Amminger, GP, Edwards, J, Brewer, WJ, Harrigan, S, McGorry, PD. Duration of untreated psychosis and cognitive deterioration in first episode schizophrenia. Schizophr Res 2002; 54: 223–30.CrossRefGoogle ScholarPubMed
34.Barnes, TR, Hutton, SB, Chapman, MJ, Mutsatsa, S, Puri, BK, Joyce, EM. West London first-episode study of schizophrenia: clinical correlates of duration of untreated psychosis. Br J Psychiatry 2000; 177: 207–11.CrossRefGoogle ScholarPubMed
35.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(9): 975–83.CrossRefGoogle ScholarPubMed