title: The effect of clozapine on the course of illness in chronic schizophrenia: focus on treatment outcome in out-patients.
abstract: Forty-eight consecutive schizophrenic patients treated with clozapine (mean daily dose 436 mg) for at least 1 year (mean 7.6, range 2.2-14.8 years) were studied retrospectively. The most favourable changes in the course of illness were observed in 39 out-patients, whose duration of hospitalization per year continuously and significantly declined after the introduction of clozapine. The out-patients who continued with clozapine treatment for more than 10 years (n = 8) did not need hospitalization at all during the last year of the observation period. The improvement in social functioning in the out-patient group correlated positively with the duration of clozapine medication (r = 0.384, p = 0.016) and with the duration of hospitalization (r = 0.372, p = 0.020) after introduction of clozapine. Out-patients with disorganized schizophrenia (later called hebephrenic according to the Finish version of DSM-III) showed more noticeable clinical (U = 226, p = 0.032) and social (U = 233, p = 0.024) improvements than non-hebephrenic patients. There appears to be a subgroup of hebephrenic patients who benefit from clozapine more than patients with other types of schizophrenia.
authors.affiliation: Department of Psychiatry, University of Helsinki, Finland.
authors.forename: G
authors.initials: G
authors.lastname: Joffe
authors.forename: E
authors.initials: E
authors.lastname: Venäläinen
authors.forename: J
authors.initials: J
authors.lastname: Tupala
authors.forename: O
authors.initials: O
authors.lastname: Hiltunen
authors.forename: K
authors.initials: K
authors.lastname: Wahlbeck
authors.forename: R
authors.initials: R
authors.lastname: Gädeke
authors.forename: R
authors.initials: R
authors.lastname: Rimon
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003024:Clozapine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012559:Schizophrenia / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003024:Clozapine