Patcharapim Takizawa
Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Kanjana Wongsiri
Department of psychiatry, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand
Pairoj Sareedenchai
Suansaranrom Psychiatric Hospital, Surat Thani, Thailand
Sucheera Amornmahaphun
Department of psychiatry, Roi-et Hospital, Roi et, Thailand
Naoaki Kuroda
Department of Public Health and Welfare, Tsukuba, Ibaraki, Japan
Ai Hori, Masao Ichikawa
Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
Abstract:
Background: To scale up the services for first-episode schizophrenia in Thailand, it is essential to understand to what extent health care-seeking is delayed, and how much the delay affects the treatment outcome. Objectives: To investigate the duration of untreated psychosis (DUP) and its impact on remission in first-episode schizophrenia across the country. Methods: 276 outpatients with a first-episode schizophrenia were followed for 6 months and assessed whether they fulfilled the criteria for remission at the follow-up. The proportion of those achieving remission was compared by the DUP. The impact of DUP on remission was estimated in multivariate analyses. Results: At the follow-up, 83% (71/86) of patients who had met the criteria for symptomatic remission at the baseline achieved enduring remission, whereas 63% (119/190) of patients who had not met the criteria for symptomatic remission at baseline met it at the follow-up. The shorter the DUP, the higher the proportion of those who achieved symptomatic or enduring remission at the follow-up. The impact of DUP on symptomatic remission appeared to be significant after controlling for other factors influencing remission. Conclusion: Since the DUP would influence remission of patients with schizophrenia, early detection and intervention services should be provided in Thailand.
Keywords:Duration of untreated psychosis, first-episode schizophrenia, remission, cohort, Thailand