Author(s): Bhushan Bhagwan Mhetre, Ranita Devi Athokapam, Sumit Rampal Chandak, Gojendra Singh Senjam, Heramani Singh Ningombam
BACKGROUND Duration of untreated psychosis (DUP) is extensively researched in recent years for its effect on first episode of psychosis. We wanted to evaluate as to whether pre-morbid functioning and duration of untreated psychosis (DUP) are related to clinical presentation of first-episode psychosis at first hospitalisation. METHODS Forty-four antipsychotic-naïve, first-episode psychosis patients were included with exclusion of organic and substance related psychosis. Patients were assessed with BPRS (Brief Psychiatric Rating Scale), SAPS (Scale for Assessment of Positive Symptoms), SANS (Scale for assessment of Negative Symptoms) and pre-morbid adjustment (PAS) scales on admission. Data was dichotomized into non-affective and affective psychosis. Spearman’s correlation and multiple regression analyses were performed using SPSS version 10. RESULTS In patients with non-affective psychosis (n=25), DUP was positively correlated to SANS score (r= 0.459, p= 0.021). In affective psychosis patients (n=19), there was positive correlation of DUP with mean PAS scores. Thus when, DUP in months is controlled, there was significant negative correlation among mean PAS score and SAPS scores at admission (p <0.05). Further, regression analysis concluded that pre-morbid functioning in patients with affective psychosis, significantly predict the composite SAPS score (Β= -0.642, p= 0.038, and R2= 0.287). This is a hospital based cross-sectional study was conducted on antipsychoticnaive patients of first episode psychosis in Regional Institute of Medical sciences, Imphal, Manipur. In the present study, 44 patients with diagnosis of first episode psychosis were studied. There were 25 cases of non-affective psychosis and 19 cases of affective psychosis. Number of males with diagnosis of first episode psychosis had been excluded. Schizophrenia was diagnosed in 12 cases and other diagnoses in non-affective group were Brief Psychotic Disorder and Psychosis NOS. In affective psychosis, mania with psychotic features was seen in 14 cases and rest 5 cases were of major depressive disorder with psychotic features. CONCLUSIONS Our findings suggest that DUP and pre-morbid functioning may be important predictors of clinical presentation of first-episode psychosis and thus, attempts for early diagnosis may also have effect on treatment response.