지역사회 거주 조현병 범주 장애 환자의 정신증 미치료 기간 관련 요인
Factors Affecting the Duration of Untreated Psychosis in Community-Dwelling Patients with Schizophrenia Spectrum Disorder
2
조회
0
다운로드
3
인용
0
참고문헌
초록
Objectives: This study aimed to identify factors affecting the duration of untreated psychosis (DUP) in patients with schizophrenia spectrum disorder. Methods: Six-hundred patients with schizophrenia spectrum disorder were recruited from mental health welfare centers in Gwangju Metropolitan City and Gyeonggi-do. Subjects were categorized into two groups according to median DUP. Demographic and clinical characteristics were compared between the two groups. Results: The mean DUP was 80.8 weeks, and the median DUP was 15.9 weeks. Patients with Medicaid, higher age, and longer duration of the schizophrenia prodrome were more likely to have a longer DUP. The DUP was shorter in patients who were consulted by family/relatives prior to treatment. Patients visiting university hospitals were more likely to have a shorter DUP compared with those visiting psychiatric clinics or small-sized mental hospitals, i.e., with less than 100 beds. A multivariate regression analysis showed that the duration of the prodrome was a factor that significantly affected DUP. Conclusion: The vulnerable group of patients with schizophrenia with a long DUP should be monitored closely. Moreover, it is necessary to develop a strategy to identify patients who have an insidious course of psychosis to reduce the DUP.
Abstract
Objectives: This study aimed to identify factors affecting the duration of untreated psychosis (DUP) in patients with schizophrenia spectrum disorder. Methods: Six-hundred patients with schizophrenia spectrum disorder were recruited from mental health welfare centers in Gwangju Metropolitan City and Gyeonggi-do. Subjects were categorized into two groups according to median DUP. Demographic and clinical characteristics were compared between the two groups. Results: The mean DUP was 80.8 weeks, and the median DUP was 15.9 weeks. Patients with Medicaid, higher age, and longer duration of the schizophrenia prodrome were more likely to have a longer DUP. The DUP was shorter in patients who were consulted by family/relatives prior to treatment. Patients visiting university hospitals were more likely to have a shorter DUP compared with those visiting psychiatric clinics or small-sized mental hospitals, i.e., with less than 100 beds. A multivariate regression analysis showed that the duration of the prodrome was a factor that significantly affected DUP. Conclusion: The vulnerable group of patients with schizophrenia with a long DUP should be monitored closely. Moreover, it is necessary to develop a strategy to identify patients who have an insidious course of psychosis to reduce the DUP.
참고문헌 (34)
- Lieberman JA, "The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches", Biol Psychiatry, 50, pp.884~897 (2001)
- Brewer WJ, "Intensive case management for high-risk patients with first-episode psychosis : service model and outcomes", Lancet Psychiatry, 2, pp.29~37 (2015)
- Norman RM, "Duration of untreated psychosis : a critical examination of the concept and its importance", Psychol Med, 31, pp.381~400 (2001)
- McGlashan TH, "Duration of untreated psychosis in first-episode schizophrenia : marker or determinant of course", Biol Psychiatry, 46, pp.899~907 (1999)
- Perkins DO, "Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia : a critical review and meta-analysis", Am J Psychiatry, 162, pp.1785~1804 (2005)
- Marshall M, "Association between duration of untreated psychosis and outcome in cohorts of first-episode patients : a systematic review", Arch Gen Psychiatry, 62, pp.975~983 (2005)
- Penttila M, "Duration of untreated psychosis as predictor of long-term outcome in schizophrenia : systematic review and meta-analysis", Br J Psychiatry, 205, pp.88~94 (2014)
- Lloyd-Evans B, "Initiatives to shorten duration of untreated psychosis : systematic review", Br J Psychiatry, 198, pp.256~263 (2011)
- Kvig EI, "Geographical accessibility and duration of untreated psychosis : distance as a determinant of treatment delay", BMC Psychiatry, 17, pp.176~ (2017)
- Fond G, "Risk factors for increased duration of untreated psychosis. Results from the FACE-SZ dataset", Schizophr Res, 195, pp.529~533 (2018)
- Kalla O, "Duration of untreated psychosis and its correlates in first-episode psychosis in Finland and Spain", Acta Psychiatr Scand, 106, pp.265~275 (2002)
- Souaiby L, "Individual factors influencing the duration of untreated psychosis", Early Interv Psychiatry, 13, pp.798~804 (2019)
- Buckley PF, "Lack of insight in schizophrenia", CNS Drugs, 21, pp.129~141 (2007)
- Broussard B, "Demographic, socio-environmental, and substancerelated predictors of duration of untreated psychosis (DUP)", Schizophr Res, 148, pp.93~98 (2013)
- Morgan C, "Clinical and social determinants of duration of untreated psychosis in the AESOP first-episode psychosis study", Br J Psychiatry, 189, pp.446~452 (2006)
- Larsen TK, "First-episode schizophrenia with long duration of untreated psychosis : pathways to care", Br J Psychiatry, 172, pp.45~52 (1998)
- Malla A, "Determinants of quality of life in first-episode psychosis", Acta Psychiatr Scand, 109, pp.46~54 (2004)
- 박선철, "초발 정신분열병 환자의 정신병 비치료기간과 관련된 정신사회적 요인", 신경정신의학, 44(4), pp.439~445 (2005), 대한신경정신의학회
- 전덕인, "정신분열병 환자에서 정신병의 비치료 기간의 임상적 관련변인", 신경정신의학, 43(4), pp.401~406 (2004), 대한신경정신의학회
- A study of duration of untreated psychosis (DUP) for first episode psychosis, "Yoo JM", Mental Health Center: The Mental Health, 12~16 (2011)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Publishing
- 이유진, "초발 정신증 삽화 환자에서 미치료 기간과 인지저하 및 음성증상과의 연관성에 관한 연구", 생물치료정신의학, 17(2), pp.211~220 (2011), 대한생물치료정신의학회
- Bora E, "Duration of untreated psychosis and neurocognition in first-episode psychosis : a meta-analysis", Schizophr Res, 193, pp.3~10 (2018)
- Galderisi S, "Correlates of cognitive impairment in first episode schizophrenia : the EUFEST study", Schizophr Res, 115, pp.104~114 (2009)
- Amminger G, "Duration of untreated psychosis and cognitive deterioration in firstepisode schizophrenia", Schizophr Res, 54, pp.223~230 (2002)
- Malla AK, "One year outcome in first episode psychosis : influence of DUP and other predictors", Schizophr Res, 54, pp.231~242 (2002)
- Loebel AD, "Duration of psychosis and outcome in first-episode schizophrenia", Am J Psychiatry, 149, pp.1183~1188 (1992)
- Lutgens D, "Predictors of cognition in first episode psychosis", Schizophr Res, 152, pp.164~169 (2014)
- Jackson HJ, "The EPPIC follow-up study of first-episode psychosis : longer-term clinical and functional outcome 7years after index admission", J Clin Psychiatry, 71, pp.716~728 (2010)
- Adamson V, "Implementing the access and waiting time standard for early intervention in psychosis in the United Kingdom : an evaluation of referrals and post?assessment outcomes over the first year of operation", Early Interv Psychiatry, 12, pp.979~986 (2018)
- Mueser KT, "The NAVIGATE program for first-episode psychosis:rationale, overview, and description of psychosocial components", Psychiatr Serv, 66, pp.680~690 (2015)
- Ito S, "Differential impacts of duration of untreated psychosis(DUP)on cognitive function in first-episode schizophrenia according to mode of onset", Eur Psychiatry, 30, pp.995~1001 (2015)
- Hui CL, "Clinical and social correlates of duration of untreated psychosis among adult-onset psychosis in Hong Kong Chinese : the JCEP study", Early Interv Psychiatry, 9, pp.118~125 (2015)
- Møller P, "The initial prodrome in schizophrenia : searching for naturalistic core dimensions of experience and behavior", Schizophr Bull, 26, pp.217~232 (2000)
