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Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A conceptual framework

Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A conceptual framework
Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A conceptual framework
The duration of untreated illness (DUI), meaning the latency to the pharmacological treatment, has been increasingly investigated in the last decade as a predictor of outcome across different psychiatric conditions, particularly in psychotic disorders. DUI is essentially computed by subtracting the age of onset of a specific disorder from the age at which the first adequate pharmacological treatment is administered. Assessment of the latency to treatment represents one of the first steps in planning early interventions. This review examines the role of the DUI in psychotic and affective disorders, focusing on neuropathological, epidemiologic, clinical and prognostic factors related to a longer latency to treatment. Through a Medline and Cochrane Library search, relevant studies up to June 2011 and other pertinent articles including meta-analyses, randomized controlled trials, naturalistic studies and clinical reviews were identified. Converging evidence indicates that a prolonged DUI negatively influences the outcome of first-episode psychosis and schizophrenia in different ways, and increasing data point toward a similar conclusion in affective disorders. Even though methodological limitations related to investigation of the DUI need to be considered, research and interventions aimed to reduce latency to treatments are object of increasing implementation worldwide. The assessment of the DUI represents one of the most important parameters to consider in this perspective, in order to quantify different latency to treatment in specific disorders and to plan related, targeted interventions.

0254-4962
14-21
Dell'Osso, B.
332b88d9-62a1-4f7b-8cd6-f5824a0a6b13
Glick, I.D.
92bb1877-070d-4cc3-b02d-8655f15e5931
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Altamura, A.C.
fceb1a27-796f-4084-a385-8e6a03073fd6
Dell'Osso, B.
332b88d9-62a1-4f7b-8cd6-f5824a0a6b13
Glick, I.D.
92bb1877-070d-4cc3-b02d-8655f15e5931
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Altamura, A.C.
fceb1a27-796f-4084-a385-8e6a03073fd6

Dell'Osso, B., Glick, I.D., Baldwin, D.S. and Altamura, A.C. (2013) Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A conceptual framework. Psychopathology, 46 (1), 14-21. (doi:10.1159/000338608). (PMID:22890286)

Record type: Article

Abstract

The duration of untreated illness (DUI), meaning the latency to the pharmacological treatment, has been increasingly investigated in the last decade as a predictor of outcome across different psychiatric conditions, particularly in psychotic disorders. DUI is essentially computed by subtracting the age of onset of a specific disorder from the age at which the first adequate pharmacological treatment is administered. Assessment of the latency to treatment represents one of the first steps in planning early interventions. This review examines the role of the DUI in psychotic and affective disorders, focusing on neuropathological, epidemiologic, clinical and prognostic factors related to a longer latency to treatment. Through a Medline and Cochrane Library search, relevant studies up to June 2011 and other pertinent articles including meta-analyses, randomized controlled trials, naturalistic studies and clinical reviews were identified. Converging evidence indicates that a prolonged DUI negatively influences the outcome of first-episode psychosis and schizophrenia in different ways, and increasing data point toward a similar conclusion in affective disorders. Even though methodological limitations related to investigation of the DUI need to be considered, research and interventions aimed to reduce latency to treatments are object of increasing implementation worldwide. The assessment of the DUI represents one of the most important parameters to consider in this perspective, in order to quantify different latency to treatment in specific disorders and to plan related, targeted interventions.

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More information

e-pub ahead of print date: 7 August 2012
Published date: 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 367935
URI: http://eprints.soton.ac.uk/id/eprint/367935
ISSN: 0254-4962
PURE UUID: 7e98edce-3ec3-4cd2-9584-b97e9a3f8d7c
ORCID for D.S. Baldwin: ORCID iD orcid.org/0000-0003-3343-0907

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Date deposited: 09 Sep 2014 13:05
Last modified: 18 Feb 2021 16:44

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Contributors

Author: B. Dell'Osso
Author: I.D. Glick
Author: D.S. Baldwin ORCID iD
Author: A.C. Altamura

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