Duration of untreated psychosis and outcomes in first-episode psychosis: systematic review and meta-analysis of early detection and intervention strategies

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• dc.contributor.author Salazar de Pablo, Gonzalo
• dc.contributor.author Guinart, Dani
• dc.contributor.author Armendariz, Alvaro
• dc.contributor.author Aymerich Nicolas, Claudia
• dc.contributor.author Catalan, Ana
• dc.contributor.author Alameda, Luis
• dc.contributor.author Rogdaki, Maria
• dc.contributor.author Martínez Baringo, Estrella
• dc.contributor.author Soler-Vidal, Joan
• dc.contributor.author Oliver, Dominic
• dc.contributor.author Rubio, José Manuel
• dc.contributor.author Arango, Celso
• dc.contributor.author Kane, John M.
• dc.contributor.author Fusar-Poli, Paolo
• dc.contributor.author Correll, Christoph U.
• dc.date.accessioned 2025-07-16T07:34:55Z
• dc.date.available 2025-07-16T07:34:55Z
• dc.date.issued 2024
• dc.description.abstract Background: The role of duration of untreated psychosis (DUP) as an early detection and intervention target to improve outcomes for individuals with first-episode psychosis is unknown. Study design: PRISMA/MOOSE-compliant systematic review to identify studies until February 1, 2023, with an intervention and a control group, reporting DUP in both groups. Random effects meta-analysis to evaluate (1) differences in DUP in early detection/intervention services vs the control group, (2) the efficacy of early detection strategies regarding eight real-world outcomes at baseline (service entry), and (3) the efficacy of early intervention strategies on ten real-world outcomes at follow-up. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD42020163640). Study results: From 6229 citations, 33 intervention studies were retrieved. The intervention group achieved a small DUP reduction (Hedges' g = 0.168, 95% CI = 0.055-0.283) vs the control group. The early detection group had better functioning levels (g = 0.281, 95% CI = 0.073-0.488) at baseline. Both groups did not differ regarding total psychopathology, admission rates, quality of life, positive/negative/depressive symptoms, and employment rates (P > .05). Early interventions improved quality of life (g = 0.600, 95% CI = 0.408-0.791), employment rates (g = 0.427, 95% CI = 0.135-0.718), negative symptoms (g = 0.417, 95% CI = 0.153-0.682), relapse rates (g = 0.364, 95% CI = 0.117-0.612), admissions rates (g = 0.335, 95% CI = 0.198-0.468), total psychopathology (g = 0.298, 95% CI = 0.014-0.582), depressive symptoms (g = 0.268, 95% CI = 0.008-0.528), and functioning (g = 0.180, 95% CI = 0.065-0.295) at follow-up but not positive symptoms or remission (P > .05). Conclusions: Comparing interventions targeting DUP and control groups, the impact of early detection strategies on DUP and other correlates is limited. However, the impact of early intervention was significant regarding relevant outcomes, underscoring the importance of supporting early intervention services worldwide.
• dc.format.mimetype application/pdf
• dc.identifier.citation Salazar de Pablo G, Guinart D, Armendariz A, Aymerich C, Catalan A, Alameda L, et al. Duration of untreated psychosis and outcomes in first-episode psychosis: systematic review and meta-analysis of early detection and intervention strategies. Schizophr Bull. 2024 Jul 27;50(4):771-83. DOI: 10.1093/schbul/sbae017
• dc.identifier.doi http://dx.doi.org/10.1093/schbul/sbae017
• dc.identifier.issn 0586-7614
• dc.identifier.uri http://hdl.handle.net/10230/70932
• dc.language.iso eng
• dc.publisher Oxford University Press
• dc.relation.ispartof Schizophr Bull. 2024 Jul 27;50(4):771-83
• dc.rights © The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work 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 detection
• dc.subject.keyword Early intervention
• dc.subject.keyword Meta-analysis
• dc.subject.keyword Outcome
• dc.title Duration of untreated psychosis and outcomes in first-episode psychosis: systematic review and meta-analysis of early detection and intervention strategies
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion