How Do Early Psychosis Services Define and Operationalize the Duration of Untreated Psychosis?

Mark Savill, Melissa Gosdin, Pooja Patel, Joy Melnikow, Rachel Loewy, Tara A Niendam

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Reducing the duration of untreated psychosis (DUP) is a key aim of early psychosis (EP) care. However, substantial variability in how the start and end points of DUP are defined impact its utility in clinical decision-making, and as an outcome measure. In this study, qualitative interviews were conducted with providers to assess how EP services and providers define, operationalize, and measure DUP. Twenty-five providers across 14 clinics were interviewed. Participants emphasized symptom frequency, conviction, distress caused, and impact when determining psychosis onset. DUP endpoint was typically identified as the first assessment in an episode of care that included an accurate diagnosis, leading to specialty EP treatment. Participants proposed a more structured operationalization of DUP, relative to those historically adopted in the literature. Integrating front-line provider perspectives could improve the accuracy of DUP measurement and address the heterogeneity in how the construct is operationalized across research and practice.

Original languageEnglish (US)
JournalJournal of Behavioral Health Services and Research
StateAccepted/In press - Jan 1 2018


  • Assessment
  • DUP
  • Psychosis onset
  • Schizophrenia
  • Treatment initiation

ASJC Scopus subject areas

  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'How Do Early Psychosis Services Define and Operationalize the Duration of Untreated Psychosis?'. Together they form a unique fingerprint.

Cite this