Outcome measures in early psychosis

Abstract

BackgroundDuration of untreated psychosis (DUP) is considered an important predictor of short-term clinical outcomeAimsTo explore the evolution of the concept of DUP, synthesise the evidence for its predictive value, highlight the problems in measurement, and consider the potential pitfalls of using DUP as a measure of the effectiveness of early intervention servicesMethodA survey of recent literature was conductedResultsSeveral studies and two systematicreviews confirm that DUP has a robust but moderate effecton outcome in schizophrenia. Studies vary widely in how DUP is defined and measured, since identifying precise time points when psychosis emerges and remits is conceptually ambiguous and clinically difficultConclusionsStandardised measurement of DUP is a vital first step in allowing comparisons between studies. Duration of untreated psychosis is a relevant measure only of the early detection function of early intervention services