BACKGROUND: Recently, the "Remission in Schizophrenia Working Group" proposed remission criteria consisting of a reduction to mild levels on key symptoms for at least 6 months. AIMS: This study applied these remission criteria to a large first-episode psychosis sample in order to (1) determine the rates of remission; (2) explore predictors of remission; and (3) test the external validity of these criteria. METHODS: We analyzed data from 462 subjects with a first-episode of psychosis who participated in a long-term, multinational, randomized, double-blinded trial of risperidone and haloperidol over 2 to 4 years. RESULTS: At some time point in the study 323 (70%) of the 462 subjects had a reduction to mild levels on the key symptoms as measured by the PANSS although only 109 (23.6%) maintained this level for at least 6 months thereby meeting remission criteria. The two strongest predictors of remission were shorter duration of untreated psychosis (p=0.01) and treatment response at 6 weeks (p=0.001). Compared to non-remitted patients, those in remission experienced greater improvement on all PANSS subscales (p<.0001), CGI-S (p<.0001), better quality of life (p=0.006), fewer relapses (p<.0001), displayed a more favorable attitude towards their medication (p=.002), had lower EPS levels according to the ESRS (p=<.0001) and received lower doses of antipsychotic medication (p=0.003). The remission and non-remission groups did not differ significantly regarding composite cognitive scores, suicidality and body mass index. CONCLUSIONS: The results suggest that the remission criteria, although based solely on core symptom improvement, can effectively identify patients who have a more favorable overall outcome.
RCT Entities:
BACKGROUND: Recently, the "Remission in Schizophrenia Working Group" proposed remission criteria consisting of a reduction to mild levels on key symptoms for at least 6 months. AIMS: This study applied these remission criteria to a large first-episode psychosis sample in order to (1) determine the rates of remission; (2) explore predictors of remission; and (3) test the external validity of these criteria. METHODS: We analyzed data from 462 subjects with a first-episode of psychosis who participated in a long-term, multinational, randomized, double-blinded trial of risperidone and haloperidol over 2 to 4 years. RESULTS: At some time point in the study 323 (70%) of the 462 subjects had a reduction to mild levels on the key symptoms as measured by the PANSS although only 109 (23.6%) maintained this level for at least 6 months thereby meeting remission criteria. The two strongest predictors of remission were shorter duration of untreated psychosis (p=0.01) and treatment response at 6 weeks (p=0.001). Compared to non-remitted patients, those in remission experienced greater improvement on all PANSS subscales (p<.0001), CGI-S (p<.0001), better quality of life (p=0.006), fewer relapses (p<.0001), displayed a more favorable attitude towards their medication (p=.002), had lower EPS levels according to the ESRS (p=<.0001) and received lower doses of antipsychotic medication (p=0.003). The remission and non-remission groups did not differ significantly regarding composite cognitive scores, suicidality and body mass index. CONCLUSIONS: The results suggest that the remission criteria, although based solely on core symptom improvement, can effectively identify patients who have a more favorable overall outcome.
Authors: Sarah R Uzenoff; David L Penn; Karen A Graham; Sylvia Saade; Barbara B Smith; Diana O Perkins Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2012-01-26 Impact factor: 4.328
Authors: M Alvarez-Jimenez; B O'Donoghue; A Thompson; J F Gleeson; S Bendall; C Gonzalez-Blanch; E Killackey; L Wunderink; P D McGorry Journal: CNS Drugs Date: 2016-05 Impact factor: 5.749
Authors: Gary Remington; Donald Addington; William Honer; Zahinoor Ismail; Thomas Raedler; Michael Teehan Journal: Can J Psychiatry Date: 2017-07-13 Impact factor: 4.356