Differences in duration of untreated psychosis for racial and ethnic minority groups with first-episode psychosis: an updated systematic review and meta-analysis

AbstractBackgroundPrevious reviews suggest there is minimal evidence for an association between duration of untreated psychosis (DUP) and neurocognition. This is based on tallied findings of studies with small samples and neurocognition viewed as a single construct. We aimed to conduct a systematic review and meta-analysis examining the association between DUP and individual neurocognitive domains and tests in first-episode psychosis (FEP).MethodMOOSE and PRISMA guidelines were followed. Forty-three studies involving 4647 FEP patients were included. For studies providing correlations between DUP and neurocognition, 12 separate meta-analyses were performed based on neurocognitive domains/indices. The influence of demographic/clinical variables was tested using weighted linear meta-regression analyses.ResultsThe relationship between DUP and most neurocognitive domains/indices was not significant. Longer DUP was associated with a larger cognitive deterioration index, i.e. current minus premorbid intellectual functioning (N = 4; mean ES −0.213, 95% confidence interval (CI) (−0.344 to −0.074), p = 0.003). Findings were homogeneous, with no evidence of publication bias or significant influence from moderators. For studies providing mean and standard deviations for neurocognitive measures and DUP, 20 meta-regressions were performed on individual neurocognitive tests. One significant finding emerged showing that longer DUP was associated with fewer Wisconsin Card Sorting Test-perseverative errors (mean ES −0.031, 95% CI (−0.048 to −0.013), p < 0.001). Exploratory meta-regressions in studies with mean DUP <360 days showed longer DUP was significantly associated with poorer performance on Trail Making Test A and B and higher Full-Scale IQ.ConclusionThere may not be a generalised association between DUP and neurocognition, however, specific cognitive functions may be associated with longer DUP or delayed help-seeking.

Download Full-text

Faculty Opinions recommendation of Efficacy and safety of individual second-generation vs. first-generation antipsychotics in first-episode psychosis: a systematic review and meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717969279.793469614 ◽

2013 ◽

Author(s):

John Davis

Keyword(s):

Systematic Review ◽

First Generation ◽

Second Generation ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Efficacy And Safety ◽

Episode Psychosis

Download Full-text

Glucose metabolism dysregulation at the onset of mental illness is not limited to first episode psychosis: A systematic review and meta‐analysis

Early Intervention in Psychiatry ◽

10.1111/eip.12749 ◽

2018 ◽

Vol 13 (5) ◽

pp. 1021-1031 ◽

Cited By ~ 6

Author(s):

Suat Kucukgoncu ◽

Urska Kosir ◽

Elton Zhou ◽

Erin Sullivan ◽

Vinod H. Srihari ◽

...

Keyword(s):

Systematic Review ◽

Mental Illness ◽

Glucose Metabolism ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis

Download Full-text

Hospitalisation and length of hospital stay following first-episode psychosis: systematic review and meta-analysis of longitudinal studies

Psychological Medicine ◽

10.1017/s0033291719000904 ◽

2019 ◽

Vol 50 (6) ◽

pp. 991-1001 ◽

Cited By ~ 2

Author(s):

Olesya Ajnakina ◽

Brendon Stubbs ◽

Emma Francis ◽

Fiona Gaughran ◽

Anthony S. David ◽

...

Keyword(s):

Systematic Review ◽

Longitudinal Studies ◽

Meta Analysis ◽

First Episode Psychosis ◽

Psychotic Symptoms ◽

First Episode ◽

Hospitalised Patients ◽

Episode Psychosis ◽

Over Time

AbstractBackgroundReducing hospitalisation and length of stay (LOS) in hospital following first episode psychosis (FEP) is important, yet reliable measures of these outcomes and their moderators are lacking. We conducted a systematic review and meta-analysis to investigate the proportion of FEP cases who were hospitalised after their first contact with services and the LOS in a hospital during follow-up.MethodsStudies were identified from a systematic search across major electronic databases from inception to October 2017. Random effects meta-analyses and meta-regression analyses were conducted.Results81 longitudinal studies encompassing data for 23 280 FEP patients with an average follow-up length of 7 years were included. 55% (95% CI 50.3–60.5%) of FEP cases were hospitalised at least once during follow-up with the pooled average LOS of 116.7 days (95% CI 95.1–138.3). Older age of illness onset and being in a stable relationship were associated with a lower proportion of people who were hospitalised. While the proportion of hospitalised patients has not decreased over time, LOS has, with the sharpest reduction in the latest time period. The proportion of patients hospitalised during follow-up was highest in Australia and New Zealand (78.4%) compared to Europe (58.1%) and North America (48.0%); and lowest in Asia (32.5%). Black ethnicity and longer duration of untreated psychosis were associated with longer LOS; while less severe psychotic symptoms at baseline were associated with shorter LOS.ConclusionOne in two FEP cases required hospitalisation at least once during a 7-year follow-up with an average length of hospitalisation of 4 months during this period. LOS has declined over time, particularly in those countries in which it was previously longest.

Download Full-text

Cannabis use and nonuse in patients with first-episode psychosis: A systematic review and meta-analysis of studies comparing neurocognitive functioning

European Psychiatry ◽

10.1192/j.eurpsy.2019.9 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Teresa Sánchez-Gutiérrez ◽

Belén Fernandez-Castilla ◽

Sara Barbeito ◽

Ana González-Pinto ◽

Juan Antonio Becerra-García ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

First Episode Psychosis ◽

Cannabis Use ◽

Effect Sizes ◽

Neurocognitive Functioning ◽

Psychotic Symptoms ◽

First Episode ◽

Moderator Variables ◽

Episode Psychosis

Abstract Background. The implications of cannabis use in the onset of early psychosis and the severity of psychotic symptoms have resulted in a proliferation of studies on this issue. However, few have examined the effects of cannabis use on the cognitive symptoms of psychosis (i.e., neurocognitive functioning) in patients with first-episode psychosis (FEP). This systematic review and meta-analysis aim to assess the neurocognitive functioning of cannabis users (CU) and nonusers (NU) with FEP. Methods. Of the 110 studies identified through the systematic review of 6 databases, 7 met the inclusion criteria, resulting in 14 independent samples and 78 effect sizes. The total sample included 304 CU with FEP and 369 NU with FEP. The moderator variables were age at first use, duration of use, percentage of males, and age. Results. Effect sizes were not significantly different from zero in any neurocognitive domain when users and NU were compared. Part of the variability in effect sizes was explained by the inclusion of the following moderator variables: (1) frequency of cannabis use (β = 0.013, F = 7.56, p = 0.017); (2) first-generation antipsychotics (β = 0.019, F = 34.46, p ≤ 0.001); and (3) country where the study was carried out (β = 0.266, t = 2.06, p = 0.043). Conclusions. This meta-analysis indicates that cannabis use is not generally associated with neurocognitive functioning in patients with FEP. However, it highlights the deleterious effect of low doses of cannabis in some patients. It also stresses the importance of the type of antipsychotic prescription and cannabis dose as moderator variables in the neurocognitive functioning of CU with FEP.

Download Full-text