Background:
Studies performed to assess the relevance of duration of untreated psychosis (DUP) as a predictor of long-term outcome (i.e. follow-ups of ten years or more) are somewhat limited. The aim of this study was to evaluate the potential association between DUP and very long-term outcome (approx. 25 yrs) of schizophrenia by means of a retrospective design. Methods: retrospective data obtained from clinical records for a cohort of 80 outpatients (52 Males, 28 Females, mean age 51+/- 11.58 years) affected by schizophrenia according to DSMIVTR attending a university community mental health centre took part in the study. Results: Mean duration of follow up was 25.2 +/- 8.68 years; Mean duration of untreated psychosis was 49.00+/-78.86 months, with no significant difference according to gender. Patients with a shorter DUP (=/< year) displayed more frequent "favourable" courses of illness (28.9% vs 8.6%) (p=0.025), more frequent cases with limited (=/<3) number of hospital admissions (85.7% vs 62.1%) (p=0.047) and a better functioning (mean GAF score=50.32+/-16.49 vs 40.26+/-9.60, p=0.02). Conclusion: a shorter DUP appears to act as a significant predictor of better outcome in schizophrenia even in the very long-term.