M Lambert1, D Naber, F X Eich, M Schacht, M Linden, B G Schimmelmann. 1. Psychosis Early Detection and Intervention Centre (PEDIC), Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy of the University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. lambert@uke.uni-hamburg.de
Abstract
UNLABELLED: Studies of subjective wellbeing (SW) in schizophrenia have missed to define and to assess rate and predictors of SW response (SW-res) and SW remission (SW-rem). METHOD: A total of 727 patients with schizophrenia and severely impaired SW at entry (Subjective Wellbeing under Neuroleptics Scale, short version, SWN-K, total score < or =60) were treated with amisulpride over 12 weeks. SW-res was defined as SWN total score increase of at least 20% and by at least 10 points and SW-rem as total score of > or =80 points. RESULTS: Seventy percent fulfilled the SW-res criterion at week 4. At week 4 and week 12 (endpoint), the SW response criterion distinguished between patients with or without later SW remission and overall symptomatic and functional response. While 39% fulfilled the SW-rem criterion at endpoint, only 9.1% without early SW-res were in SW-rem at follow-up. Regression analyses indicated that SW-res was mainly predicted by greater severity of positive symptoms at baseline and SW-rem by lower severity of negative symptoms and better social functioning, and particularly by early SW-res. CONCLUSION: Patients with a risk of SW non-remission need to be identified early with subsequent treatment adaptation according to recommendations for incomplete remission and treatment resistance in schizophrenia.
UNLABELLED: Studies of subjective wellbeing (SW) in schizophrenia have missed to define and to assess rate and predictors of SW response (SW-res) and SW remission (SW-rem). METHOD: A total of 727 patients with schizophrenia and severely impaired SW at entry (Subjective Wellbeing under Neuroleptics Scale, short version, SWN-K, total score < or =60) were treated with amisulpride over 12 weeks. SW-res was defined as SWN total score increase of at least 20% and by at least 10 points and SW-rem as total score of > or =80 points. RESULTS: Seventy percent fulfilled the SW-res criterion at week 4. At week 4 and week 12 (endpoint), the SW response criterion distinguished between patients with or without later SW remission and overall symptomatic and functional response. While 39% fulfilled the SW-rem criterion at endpoint, only 9.1% without early SW-res were in SW-rem at follow-up. Regression analyses indicated that SW-res was mainly predicted by greater severity of positive symptoms at baseline and SW-rem by lower severity of negative symptoms and better social functioning, and particularly by early SW-res. CONCLUSION:Patients with a risk of SW non-remission need to be identified early with subsequent treatment adaptation according to recommendations for incomplete remission and treatment resistance in schizophrenia.
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