Literature DB >> 23141372

Early prediction of clinical and functional outcome in schizophrenia.

Ofer Agid1, Cynthia O Siu, Elizabeth Pappadopulos, Douglas Vanderburg, Gary Remington.   

Abstract

UNLABELLED: The objective of this paper was to investigate the prognostic and predictive value of a small panel of independent and clinically important factors based on symptom improvement, baseline cognitive impairment, and weight change during the early treatment phase.
METHODS: The study sample was based on a double-blind, 6-month continuation study of ziprasidone and olanzapine (N=94). We developed a parsimonious 6-month GAF prediction function using a logistic regression model, and evaluated its predictive accuracy and performance using bootstrap estimates of c-statistics and error in predicted probability.
RESULTS: At up to 6 months of follow-up, 52 (55%) of all subjects treated with ziprasidone or olanzapine met the responder criterion of ≥50% improvement in GAF. At Week 2 (acute phase), the majority of ziprasidone (75%) and olanzapine (70%) patients showed greater than 25% improvement in the BPRS psychotic symptom subscale score. These early psychotic symptom responders (Week 2) showed significantly greater improvement in global functioning than early non-responders at all time points (Week 6 and Month 6) (all p's<0.05), confirming early response as an indicator of continued responsiveness to treatment over at least 6 months. A multivariate prediction function based on baseline neurocognitive scores and GAF, early reduction of psychotic symptoms at 2 weeks, and percentage of weight change observed at 6 weeks (All p's <0.05), showed statistically acceptable predictive performance (boostrap c-statistics=0.8598).
CONCLUSIONS: Our findings suggest that a parsimonious model incorporating a psychotic symptom assessment score, baseline neurocognitive performance, and risk of weight gain can be developed for predicting patients' likelihood of achieving favorable, long-term treatment outcomes.
Copyright © 2012 Elsevier B.V. and ECNP. All rights reserved.

Entities:  

Keywords:  Benefit–risk profile; Cognitive impairment; Early psychotic response; Global functioning; Predictive function; Weight gain

Mesh:

Substances:

Year:  2012        PMID: 23141372     DOI: 10.1016/j.euroneuro.2012.10.005

Source DB:  PubMed          Journal:  Eur Neuropsychopharmacol        ISSN: 0924-977X            Impact factor:   4.600


  6 in total

Review 1.  Current Data on and Clinical Insights into the Treatment of First Episode Nonaffective Psychosis: A Comprehensive Review.

Authors:  Benedicto Crespo-Facorro; Jose Maria Pelayo-Teran; Jacqueline Mayoral-van Son
Journal:  Neurol Ther       Date:  2016-08-23

Review 2.  The Complex Relationship between Antipsychotic-Induced Weight Gain and Therapeutic Benefits: A Systematic Review and Implications for Treatment.

Authors:  Alex T Raben; Victoria S Marshe; Araba Chintoh; Ilona Gorbovskaya; Daniel J Müller; Margaret K Hahn
Journal:  Front Neurosci       Date:  2018-01-22       Impact factor: 4.677

Review 3.  Prediction of response to drug therapy in psychiatric disorders.

Authors:  Shani Stern; Sara Linker; Krishna C Vadodaria; Maria C Marchetto; Fred H Gage
Journal:  Open Biol       Date:  2018-05       Impact factor: 6.411

4.  Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis.

Authors:  Paola Dazzan; Julia M Lappin; Margaret Heslin; Kim Donoghue; Ben Lomas; Uli Reininghaus; Adanna Onyejiaka; Tim Croudace; Peter B Jones; Robin M Murray; Paul Fearon; Gillian A Doody; Craig Morgan
Journal:  Psychol Med       Date:  2019-07-25       Impact factor: 7.723

5.  Factors associated with early response to olanzapine and clinical and functional outcomes of early responders treated for schizophrenia in the People's Republic of China.

Authors:  Wenyu Ye; William Montgomery; Zbigniew Kadziola; Li Liu; Haibo Xue; Michael D Stensland; Tamas Treuer
Journal:  Neuropsychiatr Dis Treat       Date:  2014-05-16       Impact factor: 2.570

6.  Association between Global Assessment of Functioning scores and indicators of functioning, severity, and prognosis in first-time schizophrenia.

Authors:  Ole Köhler; Henriette Thisted Horsdal; Lone Baandrup; Ole Mors; Christiane Gasse
Journal:  Clin Epidemiol       Date:  2016-09-02       Impact factor: 4.790

  6 in total

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