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The impact of family experience on the duration of untreated psychosis (DUP) in Hong Kong

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Abstract

Background

Previous family experience of psychotic illness may play an important role in whether and when a patient seeks help in first-episode psychosis. This study investigated the relationship between family experience of psychosis and the duration of untreated psychosis in a prospective sample of first-episode psychosis patients in Hong Kong. We also studied the effects of pre-morbid adjustment, educational level, living alone, and mode of onset as potential determinants of the duration of untreated psychosis (DUP).

Methods

A total of 131 first-episode psychosis patients in Hong Kong were recruited in a study of the DUP and related factors. The Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS) was used to measure the DUP and to provide a structured assessment of family history, educational level, household arrangement, and mode of onset.

Results

Previous family experience of psychiatric illness (the presence of another family member who has been receiving psychiatric treatment) and an acute mode of onset were significant predictors of a shorter DUP. Educational level had a modest effect on its own, but was not significant in the binary logistic regression model. Living alone had a moderate effect size, but was non-significant, possibly because of the small proportion of single-person households in the sample. The symptom profile, pre-morbid adjustment, and other demographic factors were not significantly related to the DUP.

Conclusion

In addition to the mode of onset, previous family experience plays an important role in the presentation of early psychosis. Educational efforts that target the family should be an important part of any strategy for the early detection of psychosis.

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References

  1. Harrigan SM, McGorry PD, Krstev H (2003) Does treatment delay in first-episode psychosis really matter? Psychol Med 33:97–110

    Article  CAS  PubMed  Google Scholar 

  2. McGlashan TH, Johannessen JO (1996) Early detection and intervention with schizophrenia: rationale. Schizophr Bull 22:201–222

    CAS  PubMed  Google Scholar 

  3. McGorry PD (2000) Evaluating the importance of reducing the duration of untreated psychosis. Aust N Z J Psychiatry 34(Suppl):S145–S149

    PubMed  Google Scholar 

  4. Johannessen JO (1998) Early intervention and prevention in schizophrenia—experiences from a study in Stavanger, Norway. Seishin Shinkeigaku Zasshi 100:511–522

    CAS  PubMed  Google Scholar 

  5. Malla A, Norman R, Mclean T, Scholten D, Townsend L (2003) A Canadian programme for early intervention in non-affective psychotic disorders. Aust N Z J Psychiatry 37:407–413

    PubMed  Google Scholar 

  6. Altamura AC, Bassettir R, Sassella F, Salvadori D, Mundo E (2001) Duration of untreated psychosis as a predictor of outcome in first-episode schizophrenia: a retrospective study. Schizophr Res 52:29–36

    CAS  PubMed  Google Scholar 

  7. Amminger GP, Edwards J, Brewer WJ, Harrigan S, Mcgorry PD (2002) Duration of untreated psychosis and cognitive deterioration in first-episode schizophrenia. Schizophr Res 54:223–230

    Article  CAS  PubMed  Google Scholar 

  8. Black K, Peters L, Rui Q, Milliken H, Whitehorn D, Kopala LC (2001) Duration of untreated psychosis predicts treatment outcome in an early psychosis program. Schizophr Res 47:215–222

    Article  CAS  PubMed  Google Scholar 

  9. Barnes TR, Hutton SB, Chapman MJ, Mutsatsa S, Puri BK, Joyce EM (2000) West London first-episode study of schizophrenia. Clinical correlates of duration of untreated psychosis. Br J Psychiatry 177:207–211

    CAS  PubMed  Google Scholar 

  10. Drake, Haley CJ, Akhtars S, Lewis SW (2000) Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry 177:511–515

    Article  CAS  PubMed  Google Scholar 

  11. Larsen TK, Johannessen JO, Opjordsmoen S (1998) First-episode schizophrenia with long duration of untreated psychosis. Pathways to care. Br J Psychiatry 172(Suppl):45–52

    CAS  Google Scholar 

  12. Skeate A, Jackson C, Birchwood M, Jones C (2002) Duration of untreated psychosis and pathways to care in first-episode psychosis. Investigation of help-seeking behaviour in primary care. Br J Psychiatry Suppl 43:s73–s77

    PubMed  Google Scholar 

  13. Moller P (2001) Duration of untreated psychosis: are we ignoring the mode of initial development? An extensive naturalistic case study of phenomenal continuity in first-episode schizophrenia. Psychopathology 34:8–14

    CAS  PubMed  Google Scholar 

  14. De H, Peters B, Dingemans P, Wouters L, Linszen D (2002) Attitudes of patients toward the first psychotic episode and the start of treatment. Schizophr Bull 28:431–442

    PubMed  Google Scholar 

  15. Hong Kong Census and Statistics Department (2002) Population census 2001: main report, Hong Kong: 2001 population census office, census and statistics department, Hong Kong Government

  16. Ness I, Ciment J (1999) The encyclopedia of global population and demographics, Chicago: Fitzroy Dearborn Publishers

  17. Russell C (2000) Demographics of the US, New York: New Strategist Publications, Inc

  18. Chung KF, Chen EY, Lam LC, Chen RY, Chan CK (1997) How are psychotic symptoms perceived? A comparison between patients, relatives and the general public. Aust N Z J Psychiatry 31:756–761

    CAS  PubMed  Google Scholar 

  19. Lam LC,Chan CK, Chen EY (1996) Insight and general public attitude on psychotic experiences in Hong Kong. Int J Soc Psychiatry 42:10–17

    CAS  PubMed  Google Scholar 

  20. Kay SR, Fiszbein A, Opler LA (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276

    CAS  PubMed  Google Scholar 

  21. Hafner H, Riecher-Rossler A, Hambrecht, et al. (1992) IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophr Res 6:209–223

    CAS  PubMed  Google Scholar 

  22. Foester A, Lewis S, Owen M, Murray R (1991) Pre-morbid adjustment and personality in psychosis. Effects of sex and diagnosis. Br J Psychiatry 158:171–176

    PubMed  Google Scholar 

  23. Cannons S, Potkin SG, Wyatt RJ (1982) Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 8:470–484

    CAS  PubMed  Google Scholar 

  24. Ho BC, Alicata D, Ward J, et al. (2003) Untreated initial psychosis: relation to cognitive deficits and brain morphology in firstepisode schizophrenia. Am J Psychiatry 160:142–148

    Article  PubMed  Google Scholar 

  25. Kalla O, Aaltonen J, Wahlstrom J, Lehtinen V, Garcia C, Gonzalez D (2002) Duration of untreated psychosis and its correlates in first-episode psychosis in Finland and Spain. Acta Psychiatr Scand 106:265–275

    CAS  PubMed  Google Scholar 

  26. Larsen TK, McGlashan TH, Moe LC (1996) First-episode schizophrenia: I. Early course parameters. Schizophr Bull 22:241–256

    CAS  PubMed  Google Scholar 

  27. Loebel AD, Lieberman JA, Alvia JM, Mayerhoff DI, Geiser SH, Szymanski SR (1992) Duration of psychosis and outcome in first-episode schizophrenia. Am J Psychiatry 149:1183–1188

    CAS  PubMed  Google Scholar 

  28. Kendler KS, Karkowski S, Walsh D (1996) Age at onset in schizophrenia and risk of illness in relatives.Results from the Roscommon Family Study. Br J Psychiatry 169:213–218

    CAS  PubMed  Google Scholar 

  29. Roy MA, Flaum MA, Gupta S, Jarmillo L, Andreasen NC (1994) Epidemiological and clinical correlates of familial and sporadic schizophrenia. Acta Psychiatr Scand 89:324–328

    CAS  PubMed  Google Scholar 

  30. Malaspina D, Goetz RR, Yale S, et al. (2000) Relation of familial schizophrenia to negative symptoms but not to the deficit syndrome. Am J Psychiatry 157:994–1003

    CAS  PubMed  Google Scholar 

  31. Verdoux H, Liraud F, Bergey C, Assens F, Abalan F, Van O (2001) Is the association between duration of untreated psychosis and outcome confounded? A two-year follow-up study of first-admitted patients. Schizophr Res 49:231–241

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dept. of Psychiatry, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong

    Eric Yu-Hai Chen, Ronald Yuk-Lun Chen & Ka-Fai Chung

  2. Dept. of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong

    Eva Lai-Wah Dunn, May Yin-King Miao, Wai-Song Yeung, Chi-Keung Wong, Wah-Fat Chan & Wai-Nang Tang

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  1. Eric Yu-Hai Chen
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  2. Eva Lai-Wah Dunn
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  3. May Yin-King Miao
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  4. Wai-Song Yeung
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  5. Chi-Keung Wong
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  6. Wah-Fat Chan
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  7. Ronald Yuk-Lun Chen
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  8. Ka-Fai Chung
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  9. Wai-Nang Tang
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Correspondence to Eric Yu-Hai Chen.

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Yu-Hai Chen, E., Dunn, E.LW., Miao, M.YK. et al. The impact of family experience on the duration of untreated psychosis (DUP) in Hong Kong. Soc Psychiat Epidemiol 40, 350–356 (2005). https://doi.org/10.1007/s00127-005-0908-z

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  • DOI: https://doi.org/10.1007/s00127-005-0908-z

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