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Research Letter |

Analyzing the Duration of Untreated Psychosis Quantile Regression ONLINE FIRST

Sinan Guloksuz, MD, PhD1; Fangyong Li, MPH2; Cenk Tek, MD3; Scott W. Woods, MD3; Thomas H. McGlashan, MD3; Svein Friis, MD4; Vinod H. Srihari, MD3
[+] Author Affiliations
1Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands
2Yale Center for Analytical Science, Yale School of Public Health, New Haven, Connecticut
3Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
4Institute of Clinical Medicine, University of Oslo, Oslo, Norway
JAMA Psychiatry. Published online August 31, 2016. doi:10.1001/jamapsychiatry.2016.2013
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This research letter compares differences in estimates of effect with logistic vs quantile regression when analyzing the effects of early detection efforts on the duration of untreated psychosis.

Prolonged duration of untreated psychosis (DUP) is associated with poorer outcomes across multiple health care systems.1 Early detection (ED) efforts can reduce these delays2 but face a challenge: typically skewed DUP distributions are poorly managed by commonly used statistical methods. This limits the strength and scope of inferences about ED’s effectiveness.1 Also, while reducing DUP will improve outcomes for most patients, there are some for whom a particularly long DUP is a byproduct of an insidiously unfolding illness rather than a modifiable prognostic factor.3 This highlights the need for a tool to interrogate the effect of ED across the full range of DUP.

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Differential Effect of Education by Quantile

DUP indicates duration of untreated psychosis.

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