Remission in early psychosis: Rates, predictors, and clinical and functional outcome correlates.

Full Abstract

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.

Author information

Author/s: Emsley, Robin (R); Rabinowitz, Jonathan (J); Medori, Rossella (R); Early Psychosis Global Working Group;

Affiliation: University of Stellenbosch, Tygerberg, Cape Town, South Africa.

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Schizophrenia research (Schizophr Res), published in Netherlands. (Language: eng)

Reference: 2007-Jan; vol 89 (issue 1-3) : pp 129-39

Dates: Created 2006/12/18; Completed 2007/04/03;

PMID: 17095194, status: MEDLINE (last retrieved date: 2/18/2009)

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