Untreated SMI: Deterioration
Psychiatric deterioration describes when a person with severe mental illness (SMI) begins to experience an increase in severity of their symptoms, worsened mental health, and a decrease in their ability to function. These changes in an individual’s mental state indicate the need for closer clinical observation and changes to or initiation of treatment.
The impact of untreated psychosis on outcomes for people with psychotic disorders
Several studies have found that early treatment leads to better outcomes for people with schizophrenia and other psychotic disorders. Similarly, longer durations of untreated psychosis (DUP) have been associated with more severe symptoms, poorer overall functioning, poorer insight— also called anosognosia — higher relapse rates, and decreased effectiveness of antipsychotic medication.
Our understanding of why longer durations of untreated psychosis is associated with worse outcomes is still evolving. One proposed explanation for the relationship between DUP and negative outcomes is that psychosis has a neurotoxic impact on the brain because of dopaminergic hyperactivity. Dopaminergic hyperactivity describes the prolonged elevation of dopamine, which can occur during psychotic episodes. These sustained, high levels of dopamine may cause structural changes to the brain such as a decline in the volume of some brain structures. However, the evidence to support the hypothesis that psychosis has a neurotoxic impact on the brain is still inconclusive.
Preventing long duration of untreated psychosis
The average duration of untreated psychosis in the U.S. is 74 weeks. This lengthy period of untreated psychosis can have long-lasting effects on the brain.
To ensure all people with psychosis are given timely access to treatment, more programs to identify and treat people experiencing their first episode of psychosis are needed. We must also end the “revolving door” of recovery and relapse in which people with severe mental illness cycle through emergency departments, jails, and the streets with little continuity of care.
Check out the links below to learn more about preventing untreated psychosis.
More than two-thirds of people experiencing first-episode psychosis are untreated for at least six months, according to research. This lengthy period of untreated symptoms can have significant impacts on the individual’s life and chance at recovery.
Trailblazing Discoveries: Explore Recent Research on Deterioration
Join our email list to stay informed about topics that impact people with severe mental illness. Receive weekly updates on cutting-edge research, delivered straight to your inbox.
I woke up searching frantically for my glasses on the nightstand — knocking over a glass of water before touching the wire rims. Pulling them on, I saw it was […]
Research Weekly
By Dr. Xavier Amador I have had many patients on Clozapine. It was the first atypical antipsychotic; it was synthesized in 1958 and first used in people in the 1970’s […]
Research Weekly
by Dr. Xavier Amador When my brother Henry developed schizophrenia, the impact rippled through our family in a number of specific ways. I have seen the same in countless families […]
Research Weekly
TAC is pleased to premiere Research Briefly, a periodic blog focused on timely research and pertinent information surrounding severe mental illness (SMI), with “What in the World is Anosognosia?” by […]
Research Weekly
by Hope Parker (February 7, 2024) Black individuals who are a part of the LGBTQ+ community report higher levels of psychological distress than the general population. These higher levels of […]
Research Weekly Uncategorized
by Jennifer M. Reingle Gonzalez, PhD, Rebecca Marcolina, MPH, Research, Data, & Analytics Team, and John Snook, JD, Chief Policy Officer, Meadows Mental Health Policy Institute In this guest post, […]
Research Weekly Suicide
By Shanti Silver (January 17, 2023) In December 2023, the Virginia Joint Legislative Audit and Review Commission staff released a report on Virginia’s nine state hospitals, including recommendations for the […]
Research Weekly
By Hope Parker (January 3, 2024) A new year brings new opportunities to advocate for effective, evidence-based care for people with severe mental illness. This January, Research Weekly will highlight […]
Research Weekly
(November 8, 2023) The summer of 2023 was considered the summer of extreme heat in America, with temperatures reaching the triple digits in many states across the United States. In early […]
Clinical Research Research Weekly SMI SMI Research
By Shanti Silver (November 1, 2023) Bipolar disorder is a mental illness characterized by alternating periods of depression and mania or hypomania. The disorder is estimated to impact more than […]
Clinical Research Research Weekly SMI SMI Research Suicide
By Elizabeth Sinclair Hancq Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness (SMI) and […]
Clinical Research Research Weekly SMI SMI Research Uncategorized
By Hope Parker (October 16, 2023) Black adults have greater barriers to accessing psychiatric care, such as a higher prevalence of intergenerational poverty and underinsurance, than their white counterparts. However, Black adults simultaneously remain overrepresented in […]
Clinical Research Research Weekly SMI SMI ResearchResources Feed
Learn signs and symptoms of psychosis and what to know about early intervention services for the best chance at a positive recovery outcome.
Essentials