The Effect of Untreated Illness in Youth Depression: A Cross-Sectional Study

Abstract

BACKGROUND: The existing research has mainly focused on exploring how the duration of untreated psychosis eff ects the further course of the disease. By contrast, the duration of an untreated illness (DUI) in youth depression and its impact on the further course of the disease has remained scarcely investigated.

AIM: The current study aims to determine how the duration of untreated illness aff ects the severity of the symptoms during the fi rst depressive episode and the degree to which the symptoms are reduced after treatment.

METHODS: Fifty-two young male patients (15–29 years old) were examined. First, they were hospitalized with a severe without psychotic symptoms (F32.2) and moderate (F32.1) depressive episode. The Hamilton Depression Rating Scale (HDRS), the Scale of Prodromal Symptoms (SOPS), and the Scale for Assessment of Negative Symptoms (SANS) were used to achieve the research goals. The examination was conducted twice at the time of patient admission to the hospital and before discharge. Our statistical analysis was carried out with the Statistica 12 software. The Mann–Whitney U test was used to compare the diff erences between two independent groups. The Spearman’s rank correlation coeffi cient was used to uncover any correlation between how long the illness has remained untreated and the severity of its clinical symptoms.

RESULTS: All patients were hospitalized at the fi rst depressive episode. The average duration of an untreated illness was 35.8±17.0 months. The patients were divided into two groups: the fi rst group (59.6%, n=31), with a duration of the untreated illness of more than 36 months, and the second group (40.4%, n=21), with a duration of the untreated illness of less than 36 months. A cross-group comparison between the participants showed that the reduction of HDRS scores was signifi cantly higher in the second group (p=0.019) at the time of discharge, with no diff erences in the severity of depressive symptoms (p=0.544) at the time of admission. Comorbidity was detected in 83.9% of the patients in the fi rst group and in 42.9% of the patients in the second group. A greater therapy eff ectiveness was found to exist in the second group, as the depressive symptoms score on the HDRS scale (p=0.016; U=196.0) and prodromal symptoms score on the SOPS disorganization subscale (p=0.046; U=218.0) were found to have been reduced signifi cantly.

CONCLUSION: The study showed that DUI has an impact on the reduction of depressive, negative symptoms and symptoms of disorganization in youth patients at the fi rst depressive episode. A high level of comorbidity has been uncovered, confi rming that a variety of non-psychotic and psychotic disorders in youth manifest themselves in depression at a prodromal stage, causing diffi culties in establishing diagnoses and requiring subsequent verifi cation. Future research might need to focus on exploring depressive symptoms as predictors of mental disorders in youth patients.

Keywords

youth depression / prodromal symptoms / negative symptoms / duration of untreated illness / comorbidity / effectiveness of therapy

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Funding

Russian Scientific FundРоссийский научный фонд(22-15-00437)

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