Project Summary

Branislav Mancevski M.D. (Young Investigator 2005) of the New York State Psychiatric Institute and Columbia University, plans to use autopsy tissue and medical charts of deceased schizophrenic patients in public hospitals in the 1940s and 1950s to study how the longer the time the patient remained untreated for psychoses, the more difficult it was for that individual to improve after treatment. Prolonged duration of untreated psychosis (DUP) is repeatedly associated with poor treatment response, but most studies have been confounded by factors that may influence both DUP and outcome. By studying subjects in New York State Office of Mental Health (OMH) institutions who were admitted prior to the widespread introduction of chlorpromazine to entire hospital wards in 1954, Dr. Mancevski hopes to have a population of patients in which DUP is determined only by the date of onset of psychosis. In the project, Dr. Mancevski will review the records of 200 randomly selected OMH patients with schizophrenia, admitted in 1941-43 or 1951-53, all treated with antipsychotic drugs for the first time in 1954. The two cohorts will be confined to patients whose first psychotic symptoms were within 2 years of admission (which is typical for these patients), so that DUP will be 11-15 years in the first cohort and 1-5 years in the second. Controlling for other factors that influence symptomatology, Dr. Mancevski will compare the two cohorts for persistent changes in positive symptoms, negative symptoms, and cognitive function following the initiation of antipsychotic treatment. The results will have significant implications for the value of early and sustained neuroleptic treatment, and for the interpretation of neuropathological and other biological studies.

Program Area: SCHIZOPHRENIA/PSYCHOTIC DISORDERS\Schizophrenia\Psychosis

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