Defining and predicting functional outcome in schizophrenia and schizophrenia spectrum disorders.
BACKGROUND
To assess criteria and to identify predictive factors for functional outcome. The criteria should cover all domains proposed by the Remission in Schizophrenia Working Group.


METHODS
PANSS ratings were used to evaluate the symptomatic treatment outcome of 262 inpatients with schizophrenia spectrum disorders within a naturalistic multicenter trial. Functional remission was defined as a GAF score >61 (Global Assessment of Functioning Scale), SOFAS score >61 (Social and Occupational Functioning Scale) and a SF-36 mental health subscore >40 (Medical Outcomes Study-Short Form Health Survey). Multivariate logistic regression and CART analyses were used to determine valid clinical and sociodemographic predictors.


RESULTS
In total, 52 patients (20%) fulfilled the criteria for functional remission, 125 patients (48%) achieved symptomatic resolution and when criteria for functional remission and symptomatic resolution were combined 33 patients (13%) achieved complete remission. Younger age, employment, a shorter duration of illness, a shorter length of current episode, less suicidality, and a lower PANSS negative and global subscore at admission were predictive of functional remission. The regression model showed a predictive value of more than 80%.


CONCLUSIONS
A significant association was found between functional remission and symptomatic resolution, indicating reasonable validity of the proposed definition for functional outcome. The revealed predictors for functional treatment outcome emphasize the need for psychosocial and vocational rehabilitation in schizophrenic patients.
Schennach-Wolff
Rebecca
R
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany. Rebecca.Schennach-Wolff@med.uni-muenchen.de
Jäger
Markus
M
Seemüller
Florian
F
Obermeier
Michael
M
Messer
Thomas
T
Laux
Gerd
G
Pfeiffer
Herbert
H
Naber
Dieter
D
Schmidt
Lutz G
LG
Gaebel
Wolfgang
W
Huff
Wolfgang
W
Heuser
Isabella
I
Maier
Wolfgang
W
Lemke
Matthias R
MR
Rüther
Eckart
E
Buchkremer
Gerd
G
Gastpar
Markus
M
Möller
Hans-Jürgen
HJ
Riedel
Michael
M
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis*; D012372:ROC Curve; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D055815:Young Adult