Prediction of duration of psychosis before first admission

Objective: To assess the factors predicting the delay between onset of psychotic symptoms and first admission in a population-based sample. Method: The duration of psychosis before admission was ascertained in a standardised way for 59 consecutively first-admitted patients presenting with psychotic symptoms. Results: The median of the duration of psychosis before admission was 3 months (interquartile range 0.5-14). A delay ≥ 3 months was independently predicted by family history of psychiatric hospitalisation (odds ratio [OR] = 12.1, 95% confidence interval [CI] 1.15-97.0, P = 0.02), low educational level (OR = 7.7, 95% CI 1.0-50.0, P = 0.05), poor global adjustment in the preceding year (OR = 0.93, 95% CI 0.86-0.99, P = 0.04), and by greater global severity of illness at admission (OR = 4.0, 95% CI 0.87- 18.3, P = 0.07). Conclusion: As these factors are also known to predict poor outcome, our results suggest that the association between duration of untreated psychosis and poor prognosis may be mediated, at least in part, by such demographic and clinical variables.