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Association between symptomatic remission and functional outcome in first-episode schizophrenia

Boden, Robert; Sundstrom, Johan; Lindström, Eva LU and Lindstrom, Leif (2009) In Schizophrenia Research 107(2-3). p.232-237
Abstract
Although operational criteria for remission in schizophrenia have recently been proposed, the association of this definition with broader functional outcome has not yet been established in first-episode patients. The severity criteria for remission consist of a score of mild or less on eight core symptoms of schizophrenia. We applied the severity criteria for remission to a sample of patients with first-episode schizophrenia (n=76) in order to explore the association with functional outcome five years after first presentation to mental healthcare. We evaluated whether other factors than those included in the remission definition predicted good function in logistic regression models. The discriminatory capacities for remission and other... (More)
Although operational criteria for remission in schizophrenia have recently been proposed, the association of this definition with broader functional outcome has not yet been established in first-episode patients. The severity criteria for remission consist of a score of mild or less on eight core symptoms of schizophrenia. We applied the severity criteria for remission to a sample of patients with first-episode schizophrenia (n=76) in order to explore the association with functional outcome five years after first presentation to mental healthcare. We evaluated whether other factors than those included in the remission definition predicted good function in logistic regression models. The discriminatory capacities for remission and other factors for good function were tested using C-statistics. The proportions of remitters and non-remitters having good function were 73% and 17%, respectively. Furthermore, remitters had a higher level of subjective satisfaction with life. In comparison with non-remission, symptomatic remission was strongly associated with good function: odds ratio 13.2, 95% confidence interval, 4.3 to 40.3. A duration of untreated psychosis of three months or less as compared with a longer duration was associated with having good function at a five-year follow-up independently of remission status. The discriminatory capacity for symptomatic remission between having good function vs. not was acceptable (C-statistic=0.78), which was significantly improved to an excellent discriminatory capacity by adding duration of untreated psychosis less than three months (C-statistic=0.83, p=0.04). In conclusion, core symptoms of schizophrenia have an important limiting effect on functioning and subjective life satisfaction in the early course of the illness. (C) 2008 Elsevier B.V. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Schizophrenia, First-episode, Remission, Functional outcome
in
Schizophrenia Research
volume
107
issue
2-3
pages
232 - 237
publisher
Elsevier
external identifiers
  • wos:000263397600019
  • scopus:58249086381
ISSN
0920-9964
DOI
10.1016/j.schres.2008.10.004
language
English
LU publication?
yes
id
c1a65a0f-a23f-4feb-b956-27192a96dfa2 (old id 1372032)
date added to LUP
2009-05-07 14:37:43
date last changed
2017-12-10 03:47:44
@article{c1a65a0f-a23f-4feb-b956-27192a96dfa2,
  abstract     = {Although operational criteria for remission in schizophrenia have recently been proposed, the association of this definition with broader functional outcome has not yet been established in first-episode patients. The severity criteria for remission consist of a score of mild or less on eight core symptoms of schizophrenia. We applied the severity criteria for remission to a sample of patients with first-episode schizophrenia (n=76) in order to explore the association with functional outcome five years after first presentation to mental healthcare. We evaluated whether other factors than those included in the remission definition predicted good function in logistic regression models. The discriminatory capacities for remission and other factors for good function were tested using C-statistics. The proportions of remitters and non-remitters having good function were 73% and 17%, respectively. Furthermore, remitters had a higher level of subjective satisfaction with life. In comparison with non-remission, symptomatic remission was strongly associated with good function: odds ratio 13.2, 95% confidence interval, 4.3 to 40.3. A duration of untreated psychosis of three months or less as compared with a longer duration was associated with having good function at a five-year follow-up independently of remission status. The discriminatory capacity for symptomatic remission between having good function vs. not was acceptable (C-statistic=0.78), which was significantly improved to an excellent discriminatory capacity by adding duration of untreated psychosis less than three months (C-statistic=0.83, p=0.04). In conclusion, core symptoms of schizophrenia have an important limiting effect on functioning and subjective life satisfaction in the early course of the illness. (C) 2008 Elsevier B.V. All rights reserved.},
  author       = {Boden, Robert and Sundstrom, Johan and Lindström, Eva and Lindstrom, Leif},
  issn         = {0920-9964},
  keyword      = {Schizophrenia,First-episode,Remission,Functional outcome},
  language     = {eng},
  number       = {2-3},
  pages        = {232--237},
  publisher    = {Elsevier},
  series       = {Schizophrenia Research},
  title        = {Association between symptomatic remission and functional outcome in first-episode schizophrenia},
  url          = {http://dx.doi.org/10.1016/j.schres.2008.10.004},
  volume       = {107},
  year         = {2009},
}