Jonas KG, Fochtmann LJ, Perlman G, et al. - As a long duration of untreated psychosis (DUP) at first hospitalization is predictive of illness severity and worse treatment outcomes, researchers here sought to determine the mechanism of this association. Hypothesis has been made that lengthy untreated psychosis is toxic or that it indicates a more severe form of schizophrenia. Alternatively, the correlation may be an artifact of lead-time bias. In a longitudinal study of schizophrenia with 2,137 observations spanning from childhood to 20 years after first admission, they tested these hypotheses. The Suffolk County Mental Health Project provided data from 287 individuals with schizophrenia or schizoaffective disorder for this study. Analysis revealed similar declines in psychosocial function in both long- and short-DUP patients, but these declines occurred at different times relative to first admission. Most of these declines occurred prior to first admission in long-DUP patients, while declines were noted after first admission in short-DUP patients. DUP was not identified to be predictive of illness course when psychosocial function was analyzed relative to psychosis onset. These findings suggest the correlation between DUP and psychosocial function to be an artifact of early detection, giving the illusion that early intervention is linked with improved outcomes.