Duration of untreated psychosis and 12-month outcome in first-episode psychosis: the impact of treatment approach

Objective: Early intervention research is examining whether reducing the duration of untreated psychosis (DUP) leads to improved outcome from first-episode psychosis. Another key influence may be the quality of treatment after initiation of care. This study examined the effect of phase-specific treatment on 12-month outcome for different categories of DUP. Method: A total of 250 first-episode psychosis cases were followed up 12 months after stabilization. The sample consisted of two historically sequential cohorts treated in the same region within different service models, one of which was more intensive and phase-specific. Outcome was compared according to four predefined categories of DUP. Results: Only patients with a mid-range DUP of 1-6 months who were treated within the phase-specific model experienced significantly better outcomes than patients treated within the previous model. Conclusion: These data suggest that there may be a limited window of opportunity in which to influence outcome. However, the complexity of this relationship is emphasized.