Prodromal Phase Before Overt Psychosis
Subtle cognitive and social changes often precede clear psychotic symptoms.
- ~1-2 yrs: Prodrome duration (typical reported range)
- ~20-35%: Conversion rate (high-risk cohorts)
- 18-25: Peak onset age (first episode psychosis)
- CAARMS/SIPS: Detection tools (at-risk screening scales)
What happens in the prodrome
Placeholder: brief functional decline and attenuated symptoms appear here.
Duration of Untreated Psychosis
DUP measures weeks from psychosis onset to first treatment contact.
- ~24 wks: Median DUP (varies widely by setting)
- >52 wks: Long DUP threshold (commonly used cutoff)
- Strong: Outcome link (shorter DUP, better outcome)
- Major driver: Care pathway delay (of prolonged DUP)
Why DUP matters
Placeholder: longer untreated psychosis correlates with worse trajectories.
Antipsychotic Treatment Initiation
First adequate antipsychotic dosing marks the treatment-start milestone.
- 2nd-gen APs: First-line agents (risperidone, olanzapine, etc.)
- 2-6 wks: Response window (early symptom change)
- High: Adherence impact (shapes remission likelihood)
- Recommended: Early intervention (coordinated specialty care)
Starting therapy
Placeholder: initiation timing and dosing set the recovery baseline.
Early vs Delayed Treatment Trajectories
Early-treated cases diverge from delayed-treated cases over time.
- Higher: Early-tx remission (vs delayed treatment group)
- Higher: Delayed-tx relapse (vs early treatment group)
- Persists: Symptom severity gap (years after onset)
- Elevated: Hospitalization risk (with longer DUP)
Diverging curves
Placeholder: the two trajectories separate soon after treatment start.
Long-Term Functional Prognosis
DUP and adherence together predict years-long functional status.
- Varies: Good outcome rate (with DUP and adherence)
- 5-10 yrs: Follow-up horizon (typical outcome studies)
- Protective: Adherence effect (reduces relapse risk)
- DUP: Key modifiable factor (reducible via early detection)
Prognosis summary
Placeholder: shorter DUP plus good adherence yields the best long-run outcome.
Placeholder: early detection programs aim to shorten DUP system-wide.