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Does duration of untreated psychosis predict very long term outcome of schizophrenic disorders? results of a retrospective study

Diego Primavera1, Chiara Bandecchi1, Tiziana Lepori1, Lucia Sanna1, Eraldo Nicotra2 and Bernardo Carpiniello1*

Author Affiliations

1 Department of Public Health, Section of Psychiatry and Psychiatric Clinic, University of Cagliari, Via Liguria 13, 09127 Cagliari, Italy

2 Department of Psychology, University of Cagliari, Via Is Mirrionis 1, 09133 Cagliari, Italy

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Annals of General Psychiatry 2012, 11:21  doi:10.1186/1744-859X-11-21

Published: 2 August 2012



Studies performed to assess the relevance of duration of untreated psychosis (DUP) as a predictor of long-term outcome (i.e. follow-ups of ten years or more) are somewhat limited. The aim of this study was to evaluate the potential association between DUP and very long-term outcome (16-33 yrs) of schizophrenia by means of a retrospective design.


Retrospective data obtained from clinical records were collected regarding DUP and outcome variables (number of hospitalizations; number of attempted suicides; course of illness; GAF scores at last observation) for a cohort of 80 outpatients (52 Males, 28 Females, mean age 51.0+/-11.58 years) affected by schizophrenia according to DSMIVTR attending a university community mental health centre.


Mean duration of follow up was 25.2 +/- 8.68 years; mean duration of untreated psychosis was 49.00 months (range 1-312 mo), with no significant difference according to gender. Patients with a shorter DUP (=/< 1 year) displayed more frequent “favourable” courses of illness (28.9% vs 8.6%) (p = 0.025), more frequent cases with limited (=/< 3) number of hospital admissions (85.7% vs 62.1%) (p = 0.047) and a better functioning (mean GAF score = 50.32+/-16.49 vs 40.26+/-9.60, p = 0.002); regression analyses confirmed that shorter DUP independently predicted a more positive outcome in terms of number of hospital admissions, course of illness, functioning (GAF scores).


A shorter DUP appears to act as a significant predictor of better outcome in schizophrenia even in the very long-term.