Evidence map›Paper›PMID 33432766›Full record

ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2021

The clinical significance of duration of untreated psychosis: an umbrella review and random-effects meta-analysis.

Oliver D Howes, Thomas Whitehurst, Ekaterina Shatalina, Leigh Townsend, Ellis Chika Onwordi, Tsz Lun Allenis Mak, Atheeshaan Arumuham, Oisín O'Brien, Maria Lobo, Luke Vano and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  9. Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2021
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  12. Early detection and intervention in at-risk mental states: rationale, structure, and clinical experience from a specialized outpatient service.Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater · 2026
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55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Oliver D HowesInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Thomas WhitehurstMRC London Institute of Medical Sciences, Hammersmith Hospital, London, UK.
Ekaterina ShatalinaMRC London Institute of Medical Sciences, Hammersmith Hospital, London, UK.
Leigh TownsendMRC London Institute of Medical Sciences, Hammersmith Hospital, London, UK.
Ellis Chika OnwordiInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Tsz Lun Allenis MakSt. George's, University of London, London, UK.
Atheeshaan ArumuhamInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Oisín O'BrienInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Maria LoboInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Luke VanoInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Uzma ZahidInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Emma ButlerInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Martin OsugoInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Funding

Medical Research Council MC_U120097115Wellcome Trust
6 · The paper itself

Abstract

The idea that a longer duration of untreated psychosis (DUP) leads to poorer outcomes has contributed to extensive changes in mental health ser-vices worldwide and has attracted considerable research interest over the past 30 years. However, the strength of the evidence underlying this notion is unclear. To address this issue, we conducted an umbrella review of available meta-analyses and performed a random-effects meta-analysis of primary studies. MEDLINE, Web of Science, PsycINFO and EMBASE were searched from inception to September 3, 2020 to identify relevant meta-analyses of studies including patients with schizophrenia spectrum disorders, first-episode psychosis, or affective and non-affective psychosis. Thirteen meta-analyses were included, corresponding to 129 individual studies with a total sample size of 25,657 patients. We detected potential violations of statistical assumptions in some of these meta-analyses. We therefore conducted a new random-effects meta-analysis of primary studies. The association between DUP and each outcome was graded according to a standardized classification into convincing, highly suggestive, suggestive, weak, or non-significant. At first presentation, there was suggestive evidence for a relationship between longer DUP and more severe negative symptoms (beta=-0.07, p=3.6×10

Indexed as

Duration of untreated psychosisfunctioningglobal psychopathologynegative symptomsoutcomespositive symptomsrecommendations for researchremissionschizophrenia

Identifiers

PMID33432766
PMCPMC7801839

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.