Delay in psychosis treatment worsens quality of life for decades

Early intervention may have clinical benefits that could last for at least 20 years after first experiencing psychosis, says an analysis of 171 people who presented in two Dublin mental health facilities between 1995 and 1999

New Irish research has found that delay in treating psychosis can worsen symptoms, functioning, and quality-of-life, and remain evident for at least 20 years after a patient first experiences the illness.

The study, led by researchers at the DETECT Early Intervention in Psychosis Service and RCSI University of Medicine and Health Sciences, has garnered international attention and was published last month in The American Journal of Psychiatry.

This longitudinal study suggests that the advantages of early detection and intervention for psychosis endure for at least 20 years. The authors found that while associations between delayed treatment and worse long-term outcome can vary depending on what outcome is measured, they are sustained across decades in a way that could not be explained by other factors.

While the importance of early detection and treatment for physical health conditions, such as cancer and heart disease, is now seen as ‘conventional wisdom’, this study indicates that this is also the case for the mental health condition of psychosis.

The study, one of the longest-running studies of its kind to be undertaken globally, involved 171 persons who first presented with psychosis to Cluain Mhuire Mental Health Service or St John of God Hospital in Dublin between 1995 and 1999. They were then studied again at six months, four, eight, 12 and 20 years later, with participants’ psychotic symptoms, functioning and quality of life assessed at each time point.

The researchers found that people with longer delays in treatment had worse outcomes 20 years later in terms of their symptoms (such as hallucinations and social withdrawal), functioning (such as employment status), and quality-of-life (such as having satisfying interpersonal relationships).

It is estimated that one out of every 100 Irish people will experience an episode of psychosis in their lifetime.

This research concludes that the longer someone experiences untreated psychosis, the poorer is their outcome for at least 20 years after the initial diagnosis. It also emphasises the importance of seeking help from mental health services, often via one’s GP, as soon as possible after people first experience the signs and symptoms of psychosis.

The research was conducted in the DETECT Early Intervention in Psychosis Service in collaboration with RCSI University of Medicine and Health Sciences and was supported by the St John of God Research Foundation through funding from the Health Research Board and the Stanley Medical Research Institute, USA.

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