It has been shown that such a reduction exists in patients as early as the first episode, with the most robust evidence in the external temporal lobe, but with reductions also in the hippocampus and frontal and parietal lobes/' However, it might be that part of the reduction is already related to an earlier origin of the disorder. Indeed, the average duration of untreated psychosis is 2.4 years, and some markers can even be traced back to the disease process long before that.7 However, the presence of similar, although lesser, gray matter reduction in relatives of patients also speaks for a congenital problem. Atrophy refers to an acquired reduction in gray matter. The acceleration of gray matter decrease seems to occur mainly during the first year(s) of the disease process. Later on, the slope of the decrement is less striking.
