Nikolai Albert1, Marianne Melau1, Heidi Jensen1, Lene Halling Hastrup2, Carsten Hjorthøj1, Merete Nordentoft1,3; 1Copenhagen Mental Health Centre, 2Psychiatric Research Unit, Region Zealand, 3University of Copenhagen
The duration of untreated psychosis (DUP) has been shown to have an effect on outcome after first episode psychosis. The premise of specialized early intervention (SEI) services is that intervention in the early years of illness can affect long-term outcomes. In this study we investigate whether DUP affects treatment response after 5 years of SEI treatment compared to 2 years of SEI treatment. As part of a randomized controlled trial testing the effect of prolonged SEI treatment 400 participants diagnosed within the schizophrenia spectrum were recruited. In the main trial, we did not find an effect on the main outcome, negative symptoms, of prolonging the SEI treatment from 2 to 5 years. In this post-hoc analysis, participants were dichotomized based on DUP, treatment delay and time from first symptom until start of SEI treatment. The participants with a short DUP (< 3 months) showed a tendency to respond better to the prolonged treatment with regards to disorganized and negative dimension. For participants with short duration from first symptom until start of SEI treatment (<6 months) there was a significant difference on the negative dimension favoring the prolonged OPUS treatment. The finding of an effect of prolonged treatment for participants with a short total treatment delay could mean that prolonged SEI treatment is more beneficial than treatment as usual so long as it is provided in the early years of illness and not just in the early years after diagnosis.
