Patient-based and clinician-based support for the remission criteria in schizophrenia.
This analysis characterizes patients with schizophrenia or schizoaffective disorder treated with risperidone who met remission criteria. In a 50-week, open-label trial, stable patients received long-acting injectable risperidone every 2 weeks. Remission criteria included severity (absent-mild ratings on core symptoms of the Positive and Negative Syndrome Scale) and duration (> or =6 months) components. The patients not remitted (severity component only) at baseline (n=394) are the subjects of this report. Measures applied included the PANSS, Clinical Global Impressions-Severity, patient-rated mental health status (Short Form-36), and Drug Attitude Inventory. Among patients who met remission criteria during the study (n=82), mean scores for all 30 PANSS items reflected absent-mild ratings at endpoint. The highest items represented an 'interpersonal' cluster, although mean ratings were still minimal to mild. Remitted patients experienced substantial improvements in Short Form-36 and Drug Attitude Inventory scores at endpoint. Although improvement occurred, it was less robust in patients who remained nonremitted (n=312). Logistic regression analysis found that remission (severity component only) was associated with a 97.1% probability of a 'not ill' rating on the Clinical Global Impressions-Severity. These remission criteria identified patients who differed from the nonremitted population on symptoms of psychopathology, medication attitude, health status, and overall clinical status, supporting the clinical validity of the remission criteria.
Docherty
John P
JP
Joan and Sanford I Weill Medical and Graduate School of Medical Science of Cornell University, New York, NY, USA.
Bossie
Cynthia A
CA
Lachaux
Bernard
B
Bouhours
Philippe
P
Zhu
Young
Y
Lasser
Robert
R
Gharabawi
Georges M
GM
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010361:Patients; D010820:Physicians; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D015203:Reproducibility of Results; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D018967:Risperidone