Évaluer la durée de psychose non traitée chez des patients souffrant de schizophrénie et son impact sur la qualité de vie et les fonctions cognitives à deux ans.

Étude transversale menée à l’hôpital Razi du mois de janvier 2014 au mois d’octobre 2014. Ont été inclus les patients hospitalisés durant la période du 1^er janvier 2011 au 31 décembre 2012 dont l’âge était supérieur à 18 ans et dont le diagnostic retenu a été celui de schizophrénie. La durée de psychose non traitée a été évaluée à l’aide du « Symptom Onset of Schizophrenia Inventory ». La qualité de vie a été évaluée à l’aide de l’auto-questionnaire « Short Form-36 Health Survey » et les fonctions cognitives à l’aide de la batterie tunisienne d’évaluation cognitive.

Notre échantillon était composé de 42 patients avec un âge moyen de 31,38 ans. La durée moyenne de psychose non traitée était de 75,38 semaines avec une médiane de 47,5 semaines. Nous avons noté que les sujets ayant une durée de psychose non traitée courte avaient une meilleure qualité de vie avec une différence significative pour le score des limitations dues à l’état psychique (p=0,01). Une durée de psychose non traitée courte était aussi significativement corrélée au rappel libre du test du « Hopkins Verbal Learning Test ».

Cette étude suggère un effet néfaste de la durée de psychose non traitée sur la qualité de vie et les fonctions cognitives chez des patients souffrant de schizophrénie à deux ans d’évolution.

The duration of untreated psychosis is defined as the interval between the first psychotic symptoms and the first starting treatment. The duration of untreated psychosis is highly variable but often prolonged and may be influenced by several factors. Some studies suggested that duration of untreated psychosis is associated with poor outcome. The objectives of this study were to assess the duration of untreated psychosis in a Tunisian cohort and its impact on the quality of life and the cognitive functions of schizophrenic patients at 2 years.

We conducted a cross sectional study at Razi Hospital between January 2014 and June 2014 that included patients with Schizophrenia diagnosis as defined in the DSMIV-TR with regular monitoring for at least 2 years. Eligible participants are those who had been hospitalized for the first time, between January 2011 and December 2012 for a first psychotic episode. Data were collected from medical records and by interviewing the patients and their family. Duration of untreated psychosis was determined using the Symptom Onset in Schizophrenia Inventory. The quality of life was assessed by the ‘Short Form-36 Health Survey’ scale in its Arabic version. All patients were evaluated with ‘The Tunisian Cognitive Battery’ composed of 7 tests. Patient scores are expressed as ‘Z scores’, which represents the position of the scores in a term of standard deviation from the mean of healthy subjects established by the authors of the battery. We divided the population into two groups based on the duration of untreated psychosis median. A short duration of untreated psychosis was lower than the median, and a long duration of untreated psychosis was equal to or greater than the median.

Our sample involved 42 patients with a mean age of 31.38 years. The average duration of untreated psychosis was 75.38 weeks with a range from 2 to 364 weeks and a median duration of 47.5 weeks. Patients with a short duration of untreated psychosis had a better quality of life with better scores for the majority of the dimensions and a significant difference in the limitations score due to the mental state (P=0.01). For cognitive function, the short duration of untreated psychosis was significantly correlated with a free recall of ‘Hopkins Verbal Learning Test’.

Our study suggest that the average duration of untreated psychosis in Tunisia is comparable to the one reported in the literature and that a short duration of untreated psychosis is correlated with better outcomes in terms of quality of life and verbal learning.