The effect of Covid-19 on duration of untreated psychosis in first-episode service

ABSTRACT

Background: During the first months of the COVID-19 pandemic presentations to emergency psychiatric services sharply declined, despite no significant change in the incidence of psychosis. Aim(s) To investigate the impact of COVID-19 on the duration of untreated psychosis (DUP) in a first-episode service. Method(s) Data was collected by the specialized treatment early in psychosis (STEP) clinic to compare the DUP pre vs. early and late pandemic stages. The onset of the pandemic was defined as the 15th of March 2020, based on an analysis of case numbers and the advent of restrictions. Outcome measures were DUP total (the time elapsed between onset of psychosis and enrolment in the STEP clinic), DUP demand (the time from onset of psychosis to first antipsychotic prescription), and DUP supply (the time from first antipsychotic prescription to enrolment into STEP). Result(s) DUP total decreased significantly (p = .008) during the early pandemic compared with pre-pandemic from a median of 208 (IQR, 24-1020.0) to 55.5 days (IQR, 8.0-560.0). During the late pandemic stage, DUP total increased back to a median of 153.5 days (IQR, 1.0- 885.0). DUP demand decreased significantly (p = .001) during the early pandemic compared to pre-pandemic from a median of 117 (IQR, 17.0-714.0) to 35 days (IQR, 2.0-541.0) and then reduced further to 27.5 (IQR, 0.0-690.0) days during the late pandemic. No significant changes were found in DUP supply (p = .24) across the different stages of the pandemic. This is the first study to show a reduction in DUP associated with the pandemic.