Duration of active psychosis: A scoping review of definition, measurement, and relationship with outcomes

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-10-07 DOI:10.1016/j.schres.2025.09.032

Paul Crowley , Jack Healy , Nick McNamara , Ralph Twomey , Ewa Sadowska , Joseph Firth , Kelly Allott , Jai Shah , Brian O'Donoghue , John Lyne

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引用次数: 0

Abstract

Background

A longer duration of untreated psychosis (DUP) is associated with poorer outcomes across a range of domains, yet this period only represents a proportion of the time individuals experience psychotic symptoms. The duration of active psychosis (DAP) concept addresses this by estimating the duration of psychosis both before and after treatment initiation. This scoping review aims to describe the literature related to this concept, with a particular focus on definition, measurement, and relationship with outcomes.

Methods

A systematic search of four databases (MEDLINE, Embase, PsycINFO, CINAHL) and the grey literature was conducted. Studies that examined DAP in individuals with first-episode psychosis were eligible for inclusion. Each article was screened independently by two reviewers. Data were extracted using a deductive approach and results were analysed using qualitative content analysis.

Results

The search yielded 3081 unique articles. 37 articles underwent full-text review and nine were eligible for inclusion. DAP is defined as the cumulative duration of two variables, the DUP and the duration of psychosis after treatment initiation (DAT). DAT measurement was mostly conducted prospectively, using a predetermined symptom severity threshold to define active psychosis. The limited studies to date report an association between longer DAP and worse cognitive and negative symptom outcomes, while longer DAT was associated with worse functional outcomes.

Conclusions

Further research is required to determine the relationship between DAP and clinical outcomes. Establishing consensus on how to define and measure DAP is critical to enhance early identification of treatment resistance and ensure timely intervention with appropriate treatments.

查看原文本刊更多论文

活动性精神病的持续时间：定义、测量和与结果的关系的范围综述。

背景：较长的精神病治疗时间（DUP）与一系列领域较差的结果相关，但这段时间仅代表个体经历精神病症状的一部分时间。活动性精神病持续时间（DAP）概念通过估计治疗开始前后精神病的持续时间来解决这个问题。这篇范围综述的目的是描述与这一概念相关的文献，特别关注定义、测量和与结果的关系。方法：系统检索MEDLINE、Embase、PsycINFO、CINAHL四个数据库和灰色文献。在首发精神病患者中检测DAP的研究符合纳入条件。每篇文章由两名审稿人独立筛选。使用演绎方法提取数据，并使用定性内容分析分析结果。结果：搜索得到3081篇独特的文章。37篇文章进行了全文审查，其中9篇符合纳入条件。DAP定义为两个变量的累积持续时间，DUP和治疗开始后精神病持续时间（DAT）。DAT测量大多是前瞻性的，使用预先确定的症状严重程度阈值来定义活动性精神病。迄今为止有限的研究报告了较长的DAP与较差的认知和阴性症状结局之间的关联，而较长的DAT与较差的功能结局相关。结论：需要进一步的研究来确定DAP与临床结果的关系。就如何定义和测量DAP达成共识对于加强早期识别治疗耐药性并确保及时采取适当治疗干预至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.