title: Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia.
abstract: OBJECTIVE
  Recently, the Remission in Schizophrenia Working Group proposed symptomatic remission criteria and pointed to the lack of data regarding functional remission and quality of life in schizophrenia. This post hoc analysis of data from German patients in the Schizophrenia Outpatient Health Outcomes study assessed rates and predictors of symptomatic and functional remission as well as adequate subjective well-being/quality of life in a large cohort of patients with schizophrenia.
  
  
  METHODS
  Data were collected in an observational 24-month follow-up study of 2960 patients with DSM-IV-defined schizophrenia recruited between January and December 2001. Complete remission required that patients achieved symptomatic remission mirroring the Remission in Schizophrenia Working Group criteria, functional remission, and a level of adequate subjective well-being over at least 6 months.
  
  
  RESULTS
  At endpoint, 47.2% of the patients achieved symptomatic remission, 26.6% achieved functional remission, and 42.2% achieved adequate subjective well-being. At endpoint, 12.8% were in complete remission. In 35.1% of patients, none of the 3 remission criteria were achieved. Only 8.7% of early nonremitted cases achieved remission at endpoint. Each single remission component as well as complete remission was mainly predicted by early remission within the first 3 months. First-line treatment with atypical antipsychotics increased the likelihood of complete remission compared to conventional antipsychotics.
  
  
  CONCLUSIONS
  Despite advances in pharmacologic and psychosocial treatments in schizophrenia, close to 90% of the patients in this study did not fulfill the combined remission criteria. This was in part attributable to the low functional remission rate, particularly the low employment rate. The finding that the course of the disorder depends on early outcome not only in previously untreated but also in more chronically ill patients points toward a critical "window of opportunity" in the course of treatment.
authors.affiliation: Psychosis Early Detection and Intervention Centre (PEDIC), Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. lambert@uke.uni-hamburg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Lambert
authors.forename: Benno G
authors.initials: BG
authors.lastname: Schimmelmann
authors.forename: Dieter
authors.initials: D
authors.lastname: Naber
authors.forename: Alexander
authors.initials: A
authors.lastname: Schacht
authors.forename: Anne
authors.initials: A
authors.lastname: Karow
authors.forename: Thomas
authors.initials: T
authors.lastname: Wagner
authors.forename: Joerg
authors.initials: J
authors.lastname: Czekalla
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D011446:Prospective Studies; D011788:Quality of Life; D012074:Remission Induction; D012559:Schizophrenia / Q000145:classification* / Q000188:drug therapy; D012720:Severity of Illness Index
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine