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

dc.contributor.authorEmsley R.
dc.contributor.authorRabinowitz J.
dc.contributor.authorMedori R.
dc.date.accessioned2011-05-15T16:02:22Z
dc.date.available2011-05-15T16:02:22Z
dc.date.issued2007
dc.identifier.citationSchizophrenia Research
dc.identifier.citation89
dc.identifier.citation03-Jan
dc.identifier.issn9209964
dc.identifier.other10.1016/j.schres.2006.09.013
dc.identifier.urihttp://hdl.handle.net/10019.1/12437
dc.description.abstractBackground: 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. © 2006 Elsevier B.V. All rights reserved.
dc.subjecthaloperidol
dc.subjectneuroleptic agent
dc.subjectrisperidone
dc.subjectadolescent
dc.subjectadult
dc.subjectarticle
dc.subjectbody mass
dc.subjectcognition
dc.subjectcomparative study
dc.subjectcontrolled study
dc.subjectdrug dose increase
dc.subjectfemale
dc.subjectfunctional assessment
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectoptimal drug dose
dc.subjectpatient attitude
dc.subjectPositive and Negative Syndrome Scale
dc.subjectpredictor variable
dc.subjectpriority journal
dc.subjectpsychosis
dc.subjectquality of life
dc.subjectrating scale
dc.subjectrelapse
dc.subjectremission
dc.subjectschizoaffective psychosis
dc.subjectschizophrenia
dc.subjectschizophreniform disorder
dc.subjectstatistical analysis
dc.subjectsuicidal ideation
dc.subjecttreatment duration
dc.subjecttreatment outcome
dc.subjecttreatment response
dc.subjectvalidity
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAntipsychotic Agents
dc.subjectDose-Response Relationship, Drug
dc.subjectDouble-Blind Method
dc.subjectDyskinesia, Drug-Induced
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHaloperidol
dc.subjectHumans
dc.subjectLong-Term Care
dc.subjectMale
dc.subjectMotivation
dc.subjectPsychiatric Status Rating Scales
dc.subjectQuality of Life
dc.subjectRecurrence
dc.subjectRisperidone
dc.subjectSchizophrenia
dc.subjectSchizophrenic Psychology
dc.subjectSick Role
dc.subjectSocial Adjustment
dc.subjectTreatment Outcome
dc.titleRemission in early psychosis: Rates, predictors, and clinical and functional outcome correlates
dc.typeArticle
dc.description.versionArticle


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