By David Douglas

NEW YORK (Reuters Health) Jun 26 - Reducing the duration of untreated psychosis helps in prevention of negative symptom psychopathologies in patients with first-episode schizophrenia, Scandinavian and US researchers report in the June issue of the Archives of General Psychiatry.

As lead investigator Dr. Ingrid Melle told Reuters Health, "It is possible to get people with first episode psychosis into treatment earlier -- through better public information and lower thresholds for access to treatment -- and that shorter duration of untreated psychosis may prevent the development of more severe negative symptoms."

Dr. Melle, of Ulleval University Hospital, Oslo and colleagues followed 231 patients after a first episode of schizophrenia, 118 of whom were from a region with specialized psychiatric services including an early detection scheme for psychosis.

Over 2 years of follow-up, all patients received similar treatments. However, patients from the region with the early detection program had a significantly lower median duration of untreated psychosis (5 weeks, versus 16 weeks in patients from the area without the early detection program), better clinical status, and milder negative symptoms at the start of treatment.

The difference in negative symptoms was maintained at 1 and 2 years. There was also a trend toward better functional and social outcome in the early detection group.

Such early treatment is clearly important, Dr. Melle points out, "since negative symptoms are more treatment resistant than positive symptoms, and thus are a major contributor to disability in people with psychotic disorders."

Arch Gen Psychiatry 2008;65:634-640.