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Sequential cross-sectional and 10-year prospective study of severe negative symptoms in relation to duration of initially untreated psychosis in chronic schizophrenia

Published online by Cambridge University Press:  09 July 2009

J. L. Waddington ,
H. A. Youssef  and
A. Kinsella
J. L. Waddington*
Affiliation:
Royal College of Surgeons in Ireland, Dublin; St Davnet's Hospital, Monaghan; Dublin Institute of Technology, Ireland
H. A. Youssef
Affiliation:
Royal College of Surgeons in Ireland, Dublin; St Davnet's Hospital, Monaghan; Dublin Institute of Technology, Ireland
A. Kinsella
Affiliation:
Royal College of Surgeons in Ireland, Dublin; St Davnet's Hospital, Monaghan; Dublin Institute of Technology, Ireland
*
1Address for correspondence: Professor John L. Waddington, Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland.
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Synopsis

Current clinical correlates of duration of initially untreated psychotic symptoms were investigated in a cross-sectional analysis followed by a 10-year prospective study among 88 inpatients with a long-standing schizophrenic illness, many of whom had experienced prolonged periods of untreated psychosis due to illness onset and hospital admission in the pre-neuroleptic era. After controlling for the effects of age, and duration and continuity of subsequent neuroleptic treatment, the primary clinical correlate of duration of initially untreated psychosis was muteness. Over the subsequent 10-year-period, no new cases of muteness emerged and some existing cases of muteness partially resolved, though the speech that emerged remained very sparse and revealed generally gross cognitive debility. The pathophysiology underlying active, unchecked psychosis may also constitute an active morbid process that is associated with the further progression of severe negative symptoms and cognitive dysfunction in the long-term.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 4 , July 1995 , pp. 849 - 857
Copyright
Copyright © Cambridge University Press 1995

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