Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset

AbstractBackgroundThe mode of onset and the course of schizophrenia illness exhibit substantial individual variations. Previous studies have pointed out that the mode of onset affects the duration of untreated psychosis (DUP) and clinical outcomes, such as cognitive and social functioning. This study attempted to clarify the association between the DUP and clinical features, taking the different modes of onset into consideration, in a prospective longitudinal study examining patients with first-episode schizophrenia.MethodsThis study was conducted in six areas of Japan. Patients with first-episode schizophrenia were followed for over 18 months. Cognitive function, psychopathology, and social functioning were assessed at baseline and at 6, 12, and 18-month follow-up points.ResultsWe identified 168 patients and sufficient information was available to determine the DUP and the mode of onset for 156 patients (92.9%): 79 had an acute onset, and 77 had an insidious onset. The DUP was significantly associated with quality of life (QOL), social functioning, and cognitive function at most of the follow-up points in the insidious-onset group. The DUP and negative symptoms at baseline were significant predictors of cognitive function at the 18-month follow-up in the insidious-onset group.ConclusionsThe present results further support the hypothesis that the DUP affects QOL, social functioning, and cognitive function over the course of illness, especially in patients with an insidious onset. Effective strategies for detecting and caring for individuals with insidious onset early during the course of schizophrenia will be essential for achieving a full patient recovery.

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Duration of untreated psychosis: impact on 2-year outcome

Psychological Medicine ◽

10.1017/s0033291703001156 ◽

2004 ◽

Vol 34 (2) ◽

pp. 277-284 ◽

Cited By ~ 102

Author(s):

J. ADDINGTON ◽

S. VAN MASTRIGT ◽

D. ADDINGTON

Keyword(s):

Longitudinal Study ◽

Social Functioning ◽

First Episode ◽

Positive Symptoms ◽

Duration Of Untreated Psychosis ◽

Methodological Issues ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal ◽

The Relationship

Background. The duration of untreated psychosis has been postulated to be a predictor of clinical outcome in schizophrenia. Although several prospective studies support the relationship, some studies do not. These differences may be due to a number of methodological issues. The objectives of this study are: (i) to address many of the methodological limitations of earlier studies such as variations in sample size and selection, type of treatment provided, differences in measurement of DUP and outcome, and length of follow-up; and (ii) to examine the relationship between DUP and outcome in a prospective longitudinal study.Method. The DUP of 200 consecutive admissions to a first-episode programme was determined. The sample was followed over 2 years and pre-morbid functioning, symptoms, social and cognitive functioning and substance use were assessed longitudinally.Results. Two years after admission to the programme, longer DUP was significantly associated with high levels of positive symptoms and poor social functioning. Independently of other variables, DUP predicted positive symptoms and social functioning at 1 and 2 years.Conclusions. There is evidence that long DUP continues to have an influence on outcome up to 2 years. These results support ongoing efforts for early detection and intervention.

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Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study

Journal of Clinical Oncology ◽

10.1200/jco.2016.68.5826 ◽

2017 ◽

Vol 35 (5) ◽

pp. 506-514 ◽

Cited By ~ 94

Author(s):

Michelle C. Janelsins ◽

Charles E. Heckler ◽

Luke J. Peppone ◽

Charles Kamen ◽

Karen M. Mustian ◽

...

Keyword(s):

Breast Cancer ◽

Cognitive Impairment ◽

Cognitive Function ◽

Reading Ability ◽

Menopausal Status ◽

Prospective Longitudinal Study ◽

Cognitive Difficulties ◽

Community Oncology ◽

Prospective Longitudinal

Purpose Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study. Patients and Methods Patients with breast cancer from community oncology clinics and age-matched noncancer controls completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) at prechemotherapy and postchemotherapy and at a 6-month follow-up as an a priori exploratory aim. Longitudinal models compared FACT-Cog scores between patients and controls at the three assessments and adjusted for age, education, race, menopausal status, and baseline reading ability, anxiety, and depressive symptoms. A minimal clinically important difference cutoff determined percentages of impairment over time. Results Of patients, 581 patients with breast cancer (mean age, 53 years; 48% anthracycline-based regimens) and 364 controls (mean age, 53 years) were assessed. Patients reported significantly greater cognitive difficulties on the FACT-Cog total score and four subscales from prechemotherapy to postchemotherapy compared with controls as well as from prechemotherapy to 6-month follow-up (all P < .001). Increased baseline anxiety, depression, and decreased cognitive reserve were significantly associated with lower FACT-Cog total scores. Treatment regimen, hormone, or radiation therapy was not significantly associated with FACT-Cog total scores in patients from postchemotherapy to 6-month follow-up. Patients were more likely to report a clinically significant decline in self-reported cognitive function than were controls from prechemotherapy to postchemotherapy (45.2% v 10.4%) and from prechemotherapy to 6-month follow-up (36.5% v 13.6%). Conclusion Patients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

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Duration of untreated psychosis and social function: 1-year follow-up study of first-episode schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.049718 ◽

2008 ◽

Vol 193 (3) ◽

pp. 203-209 ◽

Cited By ~ 85

Author(s):

Thomas R. E. Barnes ◽

Verity C. Leeson ◽

Stanley H. Mutsatsa ◽

Hilary C. Watt ◽

Sam B. Hutton ◽

...

Keyword(s):

Negative Symptoms ◽

Social Function ◽

First Episode ◽

Duration Of Untreated Psychosis ◽

Clinical Difference ◽

Path Analyses ◽

First Episode Schizophrenia ◽

The Relationship ◽

Positive And Negative Symptoms

BackgroundIn first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes.AimsTo address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point.MethodSymptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later.ResultsThere was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition.ConclusionsLonger DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP.

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Progressive Brain Change in Schizophrenia: A Prospective Longitudinal Study of First-Episode Schizophrenia

Biological Psychiatry ◽

10.1016/j.biopsych.2011.05.017 ◽

2011 ◽

Vol 70 (7) ◽

pp. 672-679 ◽

Cited By ~ 198

Author(s):

Nancy C. Andreasen ◽

Peg Nopoulos ◽

Vincent Magnotta ◽

Ronald Pierson ◽

Steven Ziebell ◽

...

Keyword(s):

Longitudinal Study ◽

First Episode ◽

Prospective Longitudinal Study ◽

First Episode Schizophrenia ◽

Prospective Longitudinal ◽

Brain Change

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P03-58 - Determinants of social functioning in first-episode schizophrenia. A prospective follow-up study

European Psychiatry ◽

10.1016/s0924-9338(10)71168-8 ◽

2010 ◽

Vol 25 ◽

pp. 1179

Author(s):

K. Gorna ◽

K. Jaracz ◽

U. Wasilczyk ◽

A. Smelkowska ◽

J. Rybakowski

Keyword(s):

Social Functioning ◽

First Episode ◽

Follow Up Study ◽

First Episode Schizophrenia

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Antioxidant enzymes and weight gain in drug-naive first episode schizophrenia patients treated with risperidone for 12 weeks: a prospective longitudinal study

Current Neuropharmacology ◽

10.2174/1570159x19666210920090547 ◽

2021 ◽

Vol 19 ◽

Author(s):

Haixia Liu ◽

Rui Yu ◽

Yanan Gao ◽

Xirong Li ◽

Xiaoni Guan ◽

...

Keyword(s):

Antioxidant Enzymes ◽

Weight Gain ◽

Antioxidant Enzyme ◽

Enzyme Activities ◽

First Episode ◽

Antioxidant Enzyme Activities ◽

Healthy Controls ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

: Oxidative stress plays an important role in weight gain induced by antipsychotics in schizophrenia (SCZ). However, little is known about how antioxidant enzymes are involved in weight gain caused by risperidone monotherapy in antipsychotics-naïve first-episode (ANFE) patients with SCZ. Therefore, the main purpose of this study was to investigate the effects of risperidone on several antioxidant enzymes in patients with ANFE SCZ and the relationship between weight gain and changes in antioxidant enzyme activities. The activities of plasma superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), as well as the levels of malondialdehyde (MDA) were measured in 225 ANFE patients and 125 healthy controls. Patients were treated with risperidone monotherapy for 12 weeks. Clinical symptoms, antioxidant enzyme activities and MDA levels were measured at baseline and during follow-up. Compared with healthy controls, the patients showed higher activities of SOD and CAT, but lower MDA levels and GPx activity. At baseline, the CAT activity was associated with bodyweight or BMI. Further, based on a 7% weight increase from baseline to follow-up, we found 75 patients in the weight gain (WG) group and 150 patients in the non-WG group. Comparison between WG group and non-WG group at baseline and during the 12-week follow-up, it was found that after treatment, the SOD activity in the WG group increased while the MDA level decreased in non-WG group. Moreover, baseline SOD and GPx activities were predictors of weight gain at 12-week follow-up. These results suggest that the antioxidant defense system may have predictive value for the weight gain of ANFE SCZ patients after risperidone treatment.

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