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Objectives: Schizophrenia is a devastating disease and many patients present late for treatment due to difficulty in identifying symptoms by family members. The objective of this study is to find if there is an association between a longer duration of untreated psychosis (DUP) and poor treatment outcome in first-episode Schizophrenics and to find if there is an association between premorbid social adjustment on DUP. Methods: Anti-psychotic-naïve patients with an international classification of diseases-10 schizophrenia were evaluated 12 weeks after their first in-patient hospitalization. Association between untreated initial psychosis duration (measured from the beginning of first symptom as well as from first hospital admission) was examined by conducting the clinical interview, symptom severity by positive and negative syndrome scale, and clinical global impression scale, pre-morbid social adjustment by premorbid social adjustment (PSA) scale; and symptoms improvement after treatment by CGI-I scale. Results: Of the 57 patients studied, 57.9% showed improvement after treatment, paranoid type was more common, patients responded better when treated with combined typical and atypical antipsychotics and improvement was better when DUP was <2 years. There was a major negative correlation between positive syndrome scores and DUP. There was no association of DUP with negative syndrome score, psychopathology score and PSA score. Conclusion: DUP was an independent predictor of treatment outcome and early intervention is necessary for better prognosis.
Bharathi et al. (Tue,) studied this question.