Duration of active psychosis during early phases of the illness and functional outcome: The PAFIP 10-year follow-up study.

Introduction: Longer duration of active psychosis (presence of positive psychotic symptoms) has been associated to worsening of functional and symptomatic outcome in patients with a first-episode of psychosis. There could be a "critical period" of increased brain vulnerability in the early phases of the illness when the effect of active psychosis would be exceptionally pernicious.
Objectives: We aim to explore the impact of lengthy periods of active psychosis during early phases of illness on long-term functional outcome.
Methods: This is a prospective clinical study. We assessed the effect of the duration active psychosis in patients with a first-episode of nonaffective psychosis on long-term social functioning and functional recovery. The study consisted of a 3-year clinical follow-up and a functional evaluation performed after a 10-year period.
Results: The sample consisted of 169 patients with a first-episode of non-affective psychosis. The duration of active psychosis after treatment (DAT) during the 3-year clinical follow-up acted as predictor of social functioning at the 10-year functional evaluation (Wald: 10.705; p = .001), but not of functional recovery. The duration of untreated psychosis (DUP) did not act as a predictor of any of the two long-term measures of functional outcome.
Conclusions: Active psychosis in early phases of the illness seems to be correlated to worst long-term functionality. In this study the duration of active psychosis after treatment (DAT) was a better predictor of long-term outcome than the duration of untreated psychosis (DUP). Reducing DAT should be considered an important objective for early intervention programs.
Competing Interests: Declaration of competing interest Crespo-Facorro B has received honoraria for consulting/advisory boards from Otsuka Pharmaceuticals and lecture honoraria from Janssen Johnson & Johnson, Lundbeck, Roche and Otsuka Pharmaceutical. Pelayo-Terán JM has received lecture honoraria and travel support form Janssen Johnson & Johnson, Lundbeck and Otsuka Pharmaceutical and has performed research for Janssen Johnson & Johnson. Ayesa-Arriola R has received lecture honoraria and travel support from Lundbeck and Otsuka Pharmaceutical. Vazquez-Burgon J, Pardo de Santayana G, Gómez-Revuelta R and Ortiz-Garcia de la Foz V report no additional financial support or other relationship relevant to the subject of this article.
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