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Duration of untreated psychosis and duration of untreated illness: New Vistas

机译：未治疗的精神病持续时间和未治疗的疾病持续时间：新远景

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The duration of untreated illness (DUI), defined as the interval between the onset of a psychiatric disorder and the administration of the first pharmacological treatment, has been increasingly investigated in the last decade as a predictor of outcome across different psychiatric conditions including schizophrenia and psychotic disorders (duration of untreated psychosis), and mood and anxiety disorders. Converging evidence indicates that a prolonged DUI may be viewed as a negative prognostic factor in schizophrenia and increasing data point toward a similar conclusion in mood and anxiety disorders. Through a Medline search, the present article highlights the role of the DUI in this group of psychiatric disorders, focusing on social and psychopathological determinants of the DUI, as well as the clinical consequences related to a longer DUI in terms of outcome. Hypotheses on neurobiological mechanisms underpinning outcome differences in relation to a prolonged DUI are provided and methodological limitations related to the assessment of the DUI in published studies and clinical practice discussed. Finally, given that DUI is supposed to be a potentially modifiable prognostic factor, intervention programs aimed to reduce this variable are briefly considered and discussed.
机译：未治疗疾病的持续时间（DUI）是指精神疾病发作与首次药物治疗之间的间隔时间，在过去十年中，人们越来越多地对其进行研究，以预测包括精神分裂症和精神病在内的各种精神疾病的预后障碍（未治疗的精神病持续时间）以及情绪和焦虑症。越来越多的证据表明，延长的DUI可能被视为精神分裂症的不良预后因素，而越来越多的数据表明，情绪和焦虑症的结论相似。通过Medline搜索，本文重点介绍了DUI在这组精神疾病中的作用，重点关注DUI的社会和心理病理因素，以及就结局而言与更长DUI相关的临床后果。提供了关于与延长的DUI相关的结果差异的神经生物学机制的假设，并讨论了已发表的研究和临床实践中有关DUI评估的方法学局限性。最后，鉴于DUI被认为是潜在的可改变预后因素，因此简要讨论并讨论了旨在减少该变量的干预方案。

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