Una revisione critica sul ruolo della durata di malattia non trattata nei disturbi psichiatrici=Understanding the role of the duration of untreated illness in psychiatric disorders: a narrative review

Introduction. The duration of untreated illness (DUI) is defined as the interval between the onset of a psychiatric disorder and the administration of the first pharmacological treatment. Aim. The aim of the present article is to analyze the relationship between the DUI or the duration of untreated psychosis (DUP) and some clinical parameters in different psychiatric disorders, like major psychoses, mood disorders and anxiety disorders. Another objective is to analyze - according to the available literature - the relationship between a long DUI and neurobiological modifications occurring with the progression of the disorder and related to the clinical outcome. Finally, given that the DUI is a modifiable prognostic factor, different intervention programs aimed to reduce this variable are presented and discussed. Materials and methods. An updated review of the current literature was conducted through PubMed in order to compare different studies focused on DUI in major psychoses, depressive and anxiety disorders. Results. A significant body of evidence shows that a prolonged DUI represents a negative prognostic factor particularly in schizophrenia. Nevertheless, an increasing number of studies points toward a similar conclusion in mood and anxiety disorders as well, even though fewer studies have been published in this field. Conclusions. Given the relationship between a longer DUI and a worse outcome - not only in major psychoses but also in mood and anxiety disorders - specific intervention programs aimed to reduce the latency to treatment are definitely envisaged.