Remission, prediction and stability of symptoms in schizophrenia: A naturalistic 12-month follow-up study

Abstract

Objective. Since its introduction in 2005, schizophrenia remission consensus criteria have been used in several prospective and cross-sectional studies. The aim of this prospective assessment of patients with schizophrenia was to employ the remission criteria in a naturalistic study design. Methods. One hundred and six patients with schizophrenia (ICD10 F 20.x) were enrolled into the study during inpatient treatment. Remission criteria with respect to changes in psychopathology ratings were obtained by trained interviewers at discharge and at 12-month follow-up using BPRS. Furthermore, information on social functioning and treatment-related quality of life were assessed using GAF (Global Assessment of Functioning) and SWN-K (Subjective Wellbeing under Neuroleptic Treatment Scale). Results. A total of 13.2% of the patients were found to meet remission criteria during follow-up. While there was no significant change in the mean BPRS scores, 14.2% of the subjects showed significant worsening and 29.2% significant improvement of their psychotic symptoms. Subsequent logistic regression analysis, explaining approximately 32% of symptomatic remission variance, indicated a significant influence of BPRS-Overall-Score and independent living at discharge. Conclusions. The results of this naturalistic study indicate that only a minority of former inpatients with schizophrenia achieve remission after 1 year and relevant subgroups of patients have significant bi-directional changes in symptoms during follow-up.

Key Words::

• Schizophrenia
• remission
• follow-up
• prediction
• quality management

Acknowledgements

Thanks to all patients participating in the study.

Statement of interest

The authors Arne Wolter, Dr Norbert Krischke and Dr Wei Mooi Wong have no conflicts of interest with any commercial or other associations. Dr Preuss and Dr Zimmermann have financial interests/arrangements or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation. Dr Preuss receives or has received in the past 3 years, research support from Lundbeck and Pfizer. He is currently, or in the past 3 years has been, a consultant for Wyeth and Astra-Zeneca. He receives or has in the past 3 years, received speaking honoraria from Eli-Lilly, Janssen-Cilag, Bristol-Meyers-Squibbs, Wyeth and Novartis. Dr Zimmermann receives or has received in the past 3 years, research support from Pfizer and Janssen-Cilag. He receives or has in the past 3 years, received additional support from Eli-Lilly, Janssen-Cilag, Bristol-Meyers-Squibbs, Merz, Wyeth, Hexal, AstraZeneca, Lundbeck, Pfizer and Novartis.

Notes

¹In the project BPRS was used before July 2005. After the article from Andreasen et al. was published, PANSS was used instead. Consequently, for the recommended time criterion the BPRS and information obtained thereof solely formed the baseline at discharge without the Items “Social Passivity and Apathy” and “Deficiency or Spontaneity and Speech fluency”. At follow-up, PANSS was obtained and used as remission criteria.