Background The role of duration of untreated psychosis (DUP) as an early detection and intervention target to improve outcomes for individuals with first-episode psychosis is unknown. Study Design PRISMA/MOOSE-compliant systematic review to identify studies until February 1, 2023, with an intervention and a control group, reporting DUP in both groups. Random effects meta-analysis to evaluate (1) differences in DUP in early detection/intervention services vs the control group, (2) the efficacy of early detection strategies regarding eight real-world outcomes at baseline (service entry), and (3) the efficacy of early intervention strategies on ten real-world outcomes at follow-up. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD42020163640). Study Results From 6229 citations, 33 intervention studies were retrieved. The intervention group achieved a small DUP reduction (Hedges’ g = 0.168, 95% CI = 0.055–0.283) vs the control group. The early detection group had better functioning levels (g = 0.281, 95% CI = 0.073–0.488) at baseline. Both groups did not differ regarding total psychopathology, admission rates, quality of life, positive/negative/depressive symptoms, and employment rates (P > .05). Early interventions improved quality of life (g = 0.600, 95% CI = 0.408–0.791), employment rates (g = 0.427, 95% CI = 0.135–0.718), negative symptoms (g = 0.417, 95% CI = 0.153–0.682), relapse rates (g = 0.364, 95% CI = 0.117–0.612), admissions rates (g = 0.335, 95% CI = 0.198–0.468), total psychopathology (g = 0.298, 95% CI = 0.014–0.582), depressive symptoms (g = 0.268, 95% CI = 0.008–0.528), and functioning (g = 0.180, 95% CI = 0.065–0.295) at follow-up but not positive symptoms or remission (P > .05). Conclusions Comparing interventions targeting DUP and control groups, the impact of early detection strategies on DUP and other correlates is limited. However, the impact of early intervention was significant regarding relevant outcomes, underscoring the importance of supporting early intervention services worldwide.

中文翻译：

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未经治疗的精神病的持续时间和首发精神病的结果：早期检测和干预策略的系统回顾和荟萃分析

背景 未经治疗的精神病持续时间（DUP）作为早期检测和干预目标以改善首发精神病患者的预后的作用尚不清楚。研究设计符合 PRISMA/MOOSE 标准的系统评价，以确定 2023 年 2 月 1 日之前的研究，其中包括干预组和对照组，报告两组的 DUP。随机效应荟萃分析，用于评估 (1) 早期检测/干预服务中 DUP 与对照组的差异，(2) 早期检测策略对基线（服务进入）八个现实世界结果的有效性，以及 (3)早期干预策略对后续十种现实世界结果的有效性。我们进行了质量评估、异质性、发表偏倚和荟萃回归分析（PROSPERO：CRD42020163640）。研究结果 从 6229 次引用中，检索到 33 项干预研究。与对照组相比，干预组的 DUP 略有降低（Hedges g = 0.168，95% CI = 0.055–0.283）。早期检测组的基线功能水平较好（g = 0.281，95% CI = 0.073–0.488）。两组在总体精神病理学、入院率、生活质量、阳性/阴性/抑郁症状和就业率方面没有差异（P > .05）。早期干预改善了生活质量（g = 0.600，95% CI = 0.408–0.791）、就业率（g = 0.427，95% CI = 0.135–0.718）、阴性症状（g = 0.417，95% CI = 0.153–0.682） ）、复发率（g = 0.364，95% CI = 0.117–0.612）、入院率（g = 0.335，95% CI = 0.198–0.468）、总精神病理学（g = 0.298，95% CI = 0.014–0.582）、随访时出现抑郁症状（g = 0.268，95% CI = 0.008–0.528）和功能（g = 0.180，95% CI = 0.065–0.295），但没有出现阳性症状或缓解（P > .05）。结论 比较针对 DUP 和对照组的干预措施，早期检测策略对 DUP 和其他相关因素的影响有限。然而，早期干预对于相关结果的影响是显着的，这凸显了支持全球早期干预服务的重要性。