Longitudinal assessment of psychopathological domains over late-stage schizophrenia in relation to duration of initially untreated psychosis: 3-year prospective study in a long-term inpatient population

David J. Meagher, John F. Quinn, Stephanie Bourke, Sally Linehan, Patrice Murphy, Anthony Kinsella, James Mullaney, John L. Waddington

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)217-227
Number of pages11
JournalPsychiatry Research
Volume126
Issue number3
DOIs
Publication statusPublished - 30 May 2004

Keywords

  • Cognitive dysfunction
  • Duration of untreated psychosis
  • Factor structure
  • Prospective study
  • Psychopathology
  • Schizophrenia

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