Clinical and social determinants of a longer duration of untreated psychosis of schizophrenia in a Japanese population

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<jats:title>Abstract</jats:title><jats:p><jats:bold>Aim:</jats:bold> To measure the duration of untreated psychosis (DUP) among patients with schizophrenia in a Japanese population and to investigate clinical and social determinants of the DUP.</jats:p><jats:p><jats:bold>Methods:</jats:bold> A multicentre, retrospective study at seven medical centres in three cities (Tokyo, Toyama and Kochi) was performed. In total, 150 consecutive patients (78 men) with neuroleptic‐naïve first‐episode schizophrenia were investigated; their DUP and demographic, clinical and social variables were obtained from their medical charts and analysed.</jats:p><jats:p><jats:bold>Results:</jats:bold> The intraclass correlation coefficient for the DUP was quite good (ICC = 0.849). The mean DUP of all the subjects attending the seven psychiatric services was 20.3 months, and the median DUP was 6.0 months. Fourteen patients (9.3%) had a DUP of more than 60 months, and 47 patients, or about one‐third, had a DUP of more than 24 months. No significant differences in the mean DUPs were observed among the three cities. Patients who were employed or who were students had a significantly shorter DUP (14.3 months). The median DUP for those with an insidious onset of psychosis (<jats:italic>n</jats:italic> = 85) was 18.0 months, compared with a median of 2.0 months for those with a sudden and acute onset (<jats:italic>n</jats:italic> = 61). However, no other clinical or social variables examined in this study were associated with differences in the DUP.</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> The DUP of patients with schizophrenia is relatively long in Japan. The provision and modification of psychiatric services for easy access and a system for the early recognition and detection of mental illness are needed.</jats:p>

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