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KMID : 0605720110170020211
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Journal of the Korean Society of Biological Therapies in Psychiatry
2011 Volume.17 No. 2 p.211 ~ p.220
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Study on the Association of Duration of Untreated Period with Cognitive Impairment and Negative Symptoms in 1st Episode Psychosis
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Lee Yu-Jin
Sung Yu-mi
Yun Kyu-Wol
Kim Soo-In
Lim Weon-Jeong
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Abstract
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Objectives: There were prior studies which suggested that duration of untreated psychosis(DUP) could be related to cognitive impairment and more negative symptom in psychotic subjects. We assessed the relationship between DUP or Duration of untreated illness(DUI), which adds duration of prodrome to DUP, and cognitive impairment as well as symptom profile and functioning impairment in 1st episode psychosis.
Methods: Forty subjects with 1st episode psychosis who were diagnosed as schizophrenia, schizoaffective disorder, bipolar I disorder with psychotic feature or delusional disorder by DSM-IV-TR, varying from 18 to 50 years of age(average : 31.4 years, 21 female patients), were assessed for DUP and DUI. All subjects completed Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI) scale, General Assessment of Functioning(GAF) scale, neuropsychological battery, including Korean Wechsler Adult Intelligence Scale(K-WAIS), Rey-Kim Memory Test, and K-FENT(Kims Frontal-Executive function Neuropsychological Test).
Results: After controlling for age, sex, education level, marital status, IQ, PANSS general psychopathology subscale score and CGI-severity score, DUP showed significant negative correlation with the K-WAIS vocabulary subtest(r=-0479, p=0.006), Korean auditory verbal learning test(K-AVLT)(r=-0.405, p=0.024), memory quotient(r=-0.364, p=0.044), delayed recall(r=-0.512, p=0.003), retrieval efficiency index(r=-0.518, p=0.003). DUI showed significant negative correlations with K-WAIS vocabulary subtest(r=-0.402, p=0.025), K-AVLT(r=-0.425, p=0.017), delayed recall(r=-0.446, p=0.012), retrieval efficiency recall(r=-0.504, p=0.004). PANSS Negative subscale score and GAF past 1year highest score were correlated only with DUI(r=.508, p=.001; r=-.709, p=.000), not DUP. In the regression model, longer DUI predicted significantly more negative symptoms and lower GAF score of past 1 year highest(p=0.026, p＜0.001).
Conclusion: Current results suggested that not only duration of untreated psychotic symptom but also duration of untreated prodrome might be associated with cognitive decline in terms of memory and frontal executive functions in 1st episode psychosis. Because the patients with a more negative symptom profile may have poorer treatment response, clinical attentions are warranted to the onset of prodrome before the full blown symptoms.
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KEYWORD
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First-episode psychosis, Cognitive function, Negative symptom, Prodrome,
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