Duration of untreated psychosis (DUP) and outcome of people with schizophrenia in rural China: 14-year follow-up study

• Published in: Psychiatry research Vol. 267; pp. 340 - 345
• Main Authors: Ran, Mao-Sheng, Xiao, Yunyu, Chui, Cheryl H.K., Hu, Xian-Zhang, Yu, Yue-Hui, Peng, Man-Man, Mao, Wen-Jun, Liu, Bo, Chen Eric, Yu-Hai, Chan, Cecilia Lai-Wan
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.09.2018
• Subjects: Adolescent; Adult; Aged; China - epidemiology; Community Mental Health Services - trends; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Psychotic Disorders - diagnosis; Psychotic Disorders - epidemiology; Psychotic Disorders - psychology; Rural Population - trends; Schizophrenia - diagnosis; Schizophrenia - epidemiology; Schizophrenic Psychology; Suicide, Attempted; Time Factors; Treatment Outcome; Young Adult; China
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2018.06.043

•Duration of untreated psychosis (DUP) is associated with 14-year outcomes of schizophrenia in a Chinese rural area.•Participants with shorter DUP had significantly less positive symptoms and better social functioning than those with longer DUP.•Little difference in 14-year outcome between medication and hospitalized groups was observed.•Earlier identification and treatment, as well as better medication compliance, should be addressed in mental health policy and services. This study aims to examine the relationship between the duration of untreated psychosis (DUP) and 14-year outcomes of schizophrenia in a Chinese rural area. Participants with schizophrenia (n = 510) were identified in an epidemiological investigation of 123 572 people aged 15 years and older in 1994 and followed up in 2008 in Xinjin, Chengdu, China. Longer DUP (>6 months) was common in participants (27.3%). In 1994, participants with DUP ≤ 6 months were more likely to have a significantly lower rate of suicide attempts, shorter duration of illness and higher rate of full remission compared with those with DUP > 6 months. No significant differences were found regarding the rates of survival, suicide, death due to other causes and homelessness between individuals with shorter and longer DUP in 2008. Nevertheless, longer DUP (>6 months) of participants in 2008 was significantly associated with higher mean of PANSS total negative and general mental scores, longer duration of illness and higher rate of live alone in the logistic regression model. Earlier identification, treatment and rehabilitation, and family intervention should be addressed when developing mental health policies and delivering community mental health services.