TY - JOUR
T1 - Longitudinal assessment of psychopathological domains over late-stage schizophrenia in relation to duration of initially untreated psychosis
T2 - 3-year prospective study in a long-term inpatient population
AU - Meagher, David J.
AU - Quinn, John F.
AU - Bourke, Stephanie
AU - Linehan, Sally
AU - Murphy, Patrice
AU - Kinsella, Anthony
AU - Mullaney, James
AU - Waddington, John L.
PY - 2004/5/30
Y1 - 2004/5/30
N2 - There remains uncertainty regarding any progressive nature of psychopathology and cognitive dysfunction in late-stage schizophrenia, and whether duration of initially untreated psychosis (DUP) might be associated with such 'progression'. This study examines longitudinally, over 3 years, the psychopathology and neuropsychology in 82 inpatients with DSM-IV schizophrenia, many of whom were admitted in the pre-neuroleptic era. Increase in executive dysfunction exceeded that in general cognitive impairment. Positive but not negative symptom severity decreased modestly; the primary predictor of negative symptom severity was DUP. On index assessment, psychopathology evidenced a three-factor structure; at follow-up, psychomotor poverty evidenced greater prominence and cohesion, and was on both occasions predicted primarily by DUP, while reality distortion was altered and disorganisation disassembled into alternative elements. It would appear that as years of chronic, refractory illness accrue, psychomotor poverty becomes more sharply delineated and dominant within the overall structure of psychopathology, and its prominence is predicted enduringly by DUP.
AB - There remains uncertainty regarding any progressive nature of psychopathology and cognitive dysfunction in late-stage schizophrenia, and whether duration of initially untreated psychosis (DUP) might be associated with such 'progression'. This study examines longitudinally, over 3 years, the psychopathology and neuropsychology in 82 inpatients with DSM-IV schizophrenia, many of whom were admitted in the pre-neuroleptic era. Increase in executive dysfunction exceeded that in general cognitive impairment. Positive but not negative symptom severity decreased modestly; the primary predictor of negative symptom severity was DUP. On index assessment, psychopathology evidenced a three-factor structure; at follow-up, psychomotor poverty evidenced greater prominence and cohesion, and was on both occasions predicted primarily by DUP, while reality distortion was altered and disorganisation disassembled into alternative elements. It would appear that as years of chronic, refractory illness accrue, psychomotor poverty becomes more sharply delineated and dominant within the overall structure of psychopathology, and its prominence is predicted enduringly by DUP.
KW - Cognitive dysfunction
KW - Duration of untreated psychosis
KW - Factor structure
KW - Prospective study
KW - Psychopathology
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=2442535036&partnerID=8YFLogxK
U2 - 10.1016/j.psychres.2004.02.012
DO - 10.1016/j.psychres.2004.02.012
M3 - Article
C2 - 15157748
AN - SCOPUS:2442535036
SN - 0165-1781
VL - 126
SP - 217
EP - 227
JO - Psychiatry Research
JF - Psychiatry Research
IS - 3
ER -