Psychiatry

Longer DUP links to worse early outcomes but not definitive irreversible harm

In 30 longitudinal studies (~9,800 first-episode patients), longer duration of untreated psychosis (DUP) consistently predicted worse symptoms at 1–2 years. Associations with functional outcomes were modest and cognitive effects were minimal or inconsistent. Associations attenuated by 5–10 years and neuroimaging findings could not establish causality. Limitations include retrospective DUP measurement, variable definitions, survivor bias, and inadequate confounder control, so DUP may index illness severity rather than neurotoxicity. 1

Half of distressed inpatients receive psychosomatic-psychiatric consultation despite high offer rates

Among 589 distressed medical inpatients across three Swiss hospitals, 93.9% were offered PPC, 63.1% accepted, and 83.9% of acceptors received PPC, yielding 50% overall receipt. Non‑Swiss nationality and being on geriatric wards increased likelihood of acceptance and receipt; gynecology wards reduced progression. Age, sex, income, education, marital status, and living arrangement did not robustly predict uptake. High attrition along sequential steps suggests benefit from proactive, ward-integrated consultation-liaison approaches to improve access. 2

Next-of-kin involvement generally benefits patients and relatives but is heterogeneous

This participatory overview included 50 evidence syntheses and found generally positive effects for next-of-kin (NOK) involvement on both relatives and patients. Interventions were heterogeneous; psychoeducation was the most assessed component. Major barriers to routine implementation included system-level individualism and lack of sustainable, multi-person delivery models. 3