What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies

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  • dc.contributor.author Salazar de Pablo, Gonzalo
  • dc.contributor.author Aymerich Nicolas, Claudia
  • dc.contributor.author Guinart, Dani
  • dc.contributor.author Catalan, Ana
  • dc.contributor.author Alameda, Luis
  • dc.contributor.author Trotta, Giulia
  • dc.contributor.author Armendariz, Alvaro
  • dc.contributor.author Martínez Baringo, Estrella
  • dc.contributor.author Soler-Vidal, Joan
  • dc.contributor.author Rubio, José Manuel
  • dc.contributor.author Garrido-Torres, Nathalia
  • dc.contributor.author Gómez Vallejo, Sandra
  • dc.contributor.author Kane, John M.
  • dc.contributor.author Howes, Oliver
  • dc.contributor.author Fusar-Poli, Paolo
  • dc.contributor.author Correll, Christoph U.
  • dc.date.accessioned 2024-11-06T07:17:05Z
  • dc.date.available 2024-11-06T07:17:05Z
  • dc.date.issued 2024
  • dc.description.abstract Duration of untreated psychosis (DUP) has been associated with poor mental health outcomes. We aimed to meta-analytically estimate the mean and median DUP worldwide, evaluating also the influence of several moderating factors. This PRISMA/MOOSE-compliant meta-analysis searched for non-overlapping individual studies from inception until 9/12/2022, reporting mean ± s.d. or median DUP in patients with first episode psychosis (FEP), without language restrictions. We conducted random-effect meta-analyses, stratified analyses, heterogeneity analyses, meta-regression analyses, and quality assessment (PROSPERO:CRD42020163640). From 12 461 citations, 369 studies were included. The mean DUP was 42.6 weeks (95% confidence interval (CI) 40.6-44.6, k = 283, n = 41 320), varying significantly across continents (p < 0.001). DUP was (in descending order) 70.0 weeks (95% CI 51.6-88.4, k = 11, n = 1508) in Africa; 48.8 weeks (95% CI 43.8-53.9, k = 73, n = 12 223) in Asia; 48.7 weeks (95% CI 43.0-54.4, k = 36, n = 5838) in North America; 38.6 weeks (95% CI 36.0-41.3, k = 145, n = 19 389) in Europe; 34.9 weeks (95% CI 23.0-46.9, k = 11, n = 1159) in South America and 28.0 weeks (95% CI 20.9-35.0, k = 6, n = 1203) in Australasia. There were differences depending on the income of countries: DUP was 48.4 weeks (95% CI 43.0-48.4, k = 58, n = 5635) in middle-low income countries and 41.2 weeks (95% CI 39.0-43.4, k = 222, n = 35 685) in high income countries. Longer DUP was significantly associated with older age (β = 0.836, p < 0.001), older publication year (β = 0.404, p = 0.038) and higher proportion of non-White FEP patients (β = 0.232, p < 0.001). Median DUP was 14 weeks (Interquartile range = 8.8-28.0, k = 206, n = 37 215). In conclusion, DUP is high throughout the world, with marked variation. Efforts to identify and intervene sooner in patients with FEP, and to promote global mental health and access to early intervention services (EIS) are critical, especially in developing countries.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Salazar de Pablo G, Aymerich C, Guinart D, Catalan A, Alameda L, Trotta G, et al. What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies. Psychol Med. 2024 Mar;54(4):652-62. DOI: 10.1017/S0033291723003458
  • dc.identifier.doi http://dx.doi.org/10.1017/S0033291723003458
  • dc.identifier.issn 0033-2917
  • dc.identifier.uri http://hdl.handle.net/10230/68445
  • dc.language.iso eng
  • dc.publisher Cambridge University Press
  • dc.relation.ispartof Psychol Med. 2024 Mar;54(4):652-62
  • dc.rights © The Author(s), 2023. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Duration of untreated psychosis
  • dc.subject.keyword Early intervention
  • dc.subject.keyword First episode psychosis
  • dc.subject.keyword Meta-analysis
  • dc.title What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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