Clinical Predictors of Duration of Untreated Psychosis:Exploring Psychosocial and Clinical Predictors of Duration of Untreated Psychosis in First-Episode Psychotic Patients in Mzuzu, Malawi

Japhet Myaba ¹, Charles M. Mwale ², Vincent C. Jumbe ³

1. Department of Mental Health, Kamuzu College of Nursing, University of Malawi/Kamuzu University of Health Sciences
2. Saint John of God Hospitaller Services, Malawi.
3. Department of Health Systems and Policy, College of Medicine, University of Malawi/Kamuzu University of Health Sciences.
   * Correspondance: Japhet Myaba; jmyaba@kcn.unima.mw

Key words: Duration of untreated psychosis, First episode psychosis, psychosocial factors, Clinical factors.

Abstract
Introduction
The duration of untreated Psychosis (DUP) is a modifiable factor in the management and outcome of patients with psychosis. However, its predictive factors have not been studied much in Malawi. Our study was aimed at determining the psychosocial and clinical predictors of DUP in first episode psychosis in Malawi.
Method
A quantitative cross-sectional study, using secondary data from an early intervention study project was done in Mzuzu, Malawi. We analysed 140 adult participants enrolled in early intervention project in 2010. Data was collected using abstraction sheet to target predictive factors. We conducted univariate and multivariate logistic regression at confidence interval of 95%. We described the mean DUP, and looked at relationship of clinical and psychosocial factors with DUP.
Results
Most participants were male (60%, n=84) and single (51.4%, n=72). The median age of male participants was 31 years (Range=18 to 60), lower than females 35 years (Range=18 to 65). (what were the numbers of females). The majority of the participants’ highest education level was secondary school (63.6%, n=89), and most had DUP of ≥ 6 months (74%, n=103). We found mean DUP of 42 months (SD= ±71). Employment status, diagnosis of schizophrenia (OR=10.93, 95% C.I 3.08-38.89), and negative symptoms of psychosis were associated with DUP of ≥ 6 months. Public self-consciousness and social quality of life were associated with long DUP.
Conclusion
Our study shows psychosocial and clinical factors that predict long DUP in Malawi. This highlights the need to target these factors when working on first episode psychosis for a better outcome.