Association between Sociodemographic Factors and Severity of Psychiatric Symptoms with Duration of Untreated Psychosis in Patients with First Episode Psychosis: A Cross-sectional Study

Abstract

Introduction: The Duration of Untreated Psychosis (DUP) is the time interval between the manifestation of the first psychotic symptom in a patient and the starting of proper treatment. Though, considered as a modifiable factor in the outcome of mental illness, many confounding variables such as sociodemographic factors and illness related factors can affect the DUP. Aim: To identify the association between sociodemographic factors and the severity of psychiatric symptoms with the DUP in patients with the first episode of psychosis. Materials and Methods: A descriptive cross-sectional study conducted in the Department of Psychiatry, Government Medical College, Kottayam, Kerala, India, from March 2018 to February 2019. The first 50 consecutive patients reporting for treatment for the first time, who were diagnosed with psychotic disorders were recruited into the study. Details of the onset of psychosis were collected from the relative based on a clear, unequivocal description of symptoms by the relative. A specially designed proforma was used to gather the sociodemographic details and Brief Psychiatric Rating Scale (BPRS) was used to assess the severity of psychotic symptoms. Statistical analysis was done using independent Student’s t-test, one-way Analysis of Variance (ANOVA) and Pearson’s correlation and p-value <0.05 is considered significant. Results: The mean age of the participants was 30.46 years and males constituted 31 (62%) of the participants. A total of 32 (64%) of the participants were unmarried or married but living separately. The mean DUP was 24.3 weeks (SD=23.9 weeks) and the mean BPRS score of the participants was 57.4 (SD=10.1). Schizophrenia was the diagnosis in 28 (56%) of participants. There was a significant correlation between the DUP and BPRS with a p-value=0.021 and Pearson’s correlation coefficient of 0.326. A significant association was found between the BPRS scores and the psychiatric diagnosis, with schizophrenia having higher mean BPRS scores. Conclusion: The DUP is considered a modifiable factor in the outcome of psychotic disorders. Many factors affect the time interval between the manifestation of initial symptoms in a patient and starting of the proper treatment. A significant association was found between the DUP and the severity of psychotic symptoms as evidenced by the BPRS score.