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Remission in schizophrenia: analysis in a naturalistic setting.

Eberhard, Jonas LU ; Levander, Sten LU and Lindström, Eva LU (2009) In Comprehensive Psychiatry 50(3). p.200-208
Abstract
OBJECTIVE: To investigate the recently defined Positive and Negative Syndrome Scale for Schizophrenia remission criteria in a naturalistic setting of psychotic patients; to identify causal factors that change remission status; and to validate the criteria against global indices of illness, cognitive functions, and social outcome. METHODS: This was a longitudinal naturalistic study of 162 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders (mean illness duration, 11 years) and treated with risperidone at study entry. Symptoms, drug treatment, cognitive function, and social outcome were measured at baseline and annually for 5 years. Remission was constructed retrospectively with only indirect data on stability... (More)
OBJECTIVE: To investigate the recently defined Positive and Negative Syndrome Scale for Schizophrenia remission criteria in a naturalistic setting of psychotic patients; to identify causal factors that change remission status; and to validate the criteria against global indices of illness, cognitive functions, and social outcome. METHODS: This was a longitudinal naturalistic study of 162 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders (mean illness duration, 11 years) and treated with risperidone at study entry. Symptoms, drug treatment, cognitive function, and social outcome were measured at baseline and annually for 5 years. Remission was constructed retrospectively with only indirect data on stability over time. RESULTS: At study entry, 40% of the patients with schizophrenia were in symptomatic remission, stabilizing between 55% and 60% after a few years. The need for hospitalization became less frequent over time; initially 31%, dropping to 7% by years 4 and 5. Many patients went in and out of remission. Remission was strongly associated with global indices of illness, with intact insight and with social outcome (except work/studies) but not with cognition or medication. CONCLUSIONS: In spite of certain weaknesses of the study, we may conclude that current definition of remission is primarily a symptomatic measure, covering a subset of symptoms, some of which are not schizophrenia-specific. Although the definition may be clinically relevant, we must be aware of the risk that the connotation of the word could induce too much focus on symptom control. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Comprehensive Psychiatry
volume
50
issue
3
pages
200 - 208
publisher
Elsevier
external identifiers
  • WOS:000265655400002
  • PMID:19374962
  • Scopus:64149090606
ISSN
0010-440X
DOI
10.1016/j.comppsych.2008.08.010
language
English
LU publication?
yes
id
e3f4f843-0a0c-4e4a-9bfc-78879a7a744e (old id 1392014)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19374962?dopt=Abstract
date added to LUP
2009-05-06 13:02:50
date last changed
2016-12-02 07:43:59
@misc{e3f4f843-0a0c-4e4a-9bfc-78879a7a744e,
  abstract     = {OBJECTIVE: To investigate the recently defined Positive and Negative Syndrome Scale for Schizophrenia remission criteria in a naturalistic setting of psychotic patients; to identify causal factors that change remission status; and to validate the criteria against global indices of illness, cognitive functions, and social outcome. METHODS: This was a longitudinal naturalistic study of 162 patients, diagnosed with schizophrenia or schizophrenia-related psychotic disorders (mean illness duration, 11 years) and treated with risperidone at study entry. Symptoms, drug treatment, cognitive function, and social outcome were measured at baseline and annually for 5 years. Remission was constructed retrospectively with only indirect data on stability over time. RESULTS: At study entry, 40% of the patients with schizophrenia were in symptomatic remission, stabilizing between 55% and 60% after a few years. The need for hospitalization became less frequent over time; initially 31%, dropping to 7% by years 4 and 5. Many patients went in and out of remission. Remission was strongly associated with global indices of illness, with intact insight and with social outcome (except work/studies) but not with cognition or medication. CONCLUSIONS: In spite of certain weaknesses of the study, we may conclude that current definition of remission is primarily a symptomatic measure, covering a subset of symptoms, some of which are not schizophrenia-specific. Although the definition may be clinically relevant, we must be aware of the risk that the connotation of the word could induce too much focus on symptom control.},
  author       = {Eberhard, Jonas and Levander, Sten and Lindström, Eva},
  issn         = {0010-440X},
  language     = {eng},
  number       = {3},
  pages        = {200--208},
  publisher    = {ARRAY(0xafa7dc0)},
  series       = {Comprehensive Psychiatry},
  title        = {Remission in schizophrenia: analysis in a naturalistic setting.},
  url          = {http://dx.doi.org/10.1016/j.comppsych.2008.08.010},
  volume       = {50},
  year         = {2009},
}