Schizophrenia is often diagnosed after someone has a psychotic episode. When someone who has had a psychotic episode initially seeks treatment, however, he or she may have had a prolonged duration of untreated psychosis (DUP). This period of time has been theorized to significantly impact later symptom severity and even progression, prognosis, and outcome.
Surprisingly, even though this theory has been introduced and explored, few studies have looked at the relationship between DUP and symptoms via a long-term follow-up. Therefore, Dr. Wing Chung Chang of the Department of Psychiatry at the University of Hong Kong in China recently led a study examining the long-term effects of DUP on executive function in a sample of 93 adults with schizophrenia.
The participants ranged in age between 18 and 55, and were evaluated extensively when they first presented for treatment for psychosis. They were followed up with several other assessments over the course of the next three years. Chang measured executive functions and looked at various aspects of cognitive function and memory.
The results revealed that when compared to nonpsychotic control participants, the participants with psychosis had large deficits in areas of memory. Chang found that visual memory was especially impaired in the participants with psychosis and that verbal memory continued to experience deficits over the three-year period. Additionally, the length of DUP was directly predictive of symptom severity and outcome at three years.
Chang believes this study supports other research that demonstrates a link between DUP and illness outcome. The longer an individual experiences psychosis, the more likely they are to have a worse illness trajectory, more severe symptoms, and more impairment to cognitive capacities. Chang said, “Our findings provided further supportive evidence that delayed treatment to first-episode psychosis is associated with poorer cognitive and clinical outcomes.”
In sum, this study extends existing research into this topic by demonstrating the long-term negative effects of psychosis on cognitive function, especially verbal memory. Future work could fortify this area of research by extending the study duration even further and by examining particular shifts in cognitive deficits and how they relate to DUP.
Chang, W. C., et al. (2013). Impacts of duration of untreated psychosis on cognition and negative symptoms in first-episode schizophrenia: A 3-year prospective follow-up study. Psychological Medicine 43.9 (2013): 1883-93. ProQuest. Web.
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