Treatment response in psychotic patients classified according to social and clinical needs, drug side effects, and previous treatment; a method to identify functional remission.
BACKGROUND
Various approaches have been made over the years to classify psychotic patients according to inadequate treatment response, using terms such as treatment resistant or treatment refractory. Existing classifications have been criticized for overestimating positive symptoms; underestimating residual symptoms, negative symptoms, and side effects; or being to open for individual interpretation. The aim of this study was to present and evaluate a new method of classification according to treatment response and, thus, to identify patients in functional remission.


METHODS
A naturalistic, cross-sectional study was performed using patient interviews and information from patient files. The new classification method CANSEPT, which combines the Camberwell Assessment of Need rating scale, the Udvalg for Kliniske Undersøgelser side effect rating scale (SE), and the patient's previous treatment history (PT), was used to group the patients according to treatment response. CANSEPT was evaluated by comparison of expected and observed results.


RESULTS
In the patient population (n = 123), the patients in functional remission, as defined by CANSEPT, had higher quality of life, fewer hospitalizations, fewer psychotic symptoms, and higher rate of workers than those with the worst treatment outcome.


CONCLUSIONS
In the evaluation, CANSEPT showed validity in discriminating the patients of interest and was well tolerated by the patients. CANSEPT could secure inclusion of correct patients in the clinic or in research.
Alenius
Malin
M
Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
Hammarlund-Udenaes
Margareta
M
Hartvig
Per
P
Sundquist
Staffan
S
Lindström
Leif
L
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D017668:Age of Onset; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003702:Delusions / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011594:Psychometrics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D012050:Rehabilitation, Vocational; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D013548:Sweden; D016896:Treatment Outcome; D055815:Young Adult
D014150:Antipsychotic Agents