Time course of antipsychotic treatment response in schizophrenia: results from a naturalistic study in 280 patients.
OBJECTIVE
To describe the course of positive and negative symptoms during inpatient treatment and examine remission and response rates under routine clinical care conditions.


METHODS
Two hundred and eighty inpatients with schizophrenia (DSM-IV criteria) were assessed with the Positive and Negative Syndrome Scale (PANSS) at admission and at biweekly intervals until discharge from hospital. Remission was defined according to the symptom-severity component of the consensus criteria (Remission in Schizophrenia Working Group) as a rating of three or less in the relevant PANSS items at discharge, and response as a reduction of at least 20% in the PANSS total score from admission to discharge.


RESULTS
The mean duration of inpatient treatment was 54.8 days. Of the total sample, 78.5% achieved the criteria for response and 44.6% those for remission. Mean PANSS total scores decreased from 72.4 at admission to 52.5 at discharge (p<0.001). A reduction in PANSS total scores was found from visit to visit, up to week 8. The most pronounced decline was observed within the first two weeks of treatment.


CONCLUSIONS
Response rates were comparable to those found in efficacy studies, and remission rates were slightly higher. This may be explained by differences in the selection and the treatment of patients. Nevertheless, the findings might indicate that a complex naturalistic treatment approach is beneficial in terms of effectiveness.
Jäger
M
M
Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr 7, D-80336 Munich, Germany.
Riedel
M
M
Obermeier
M
M
Schennach-Wolff
R
R
Seemüller
F
F
Messer
T
T
Laux
G
G
Pfeiffer
H
H
Naber
D
D
Schmidt
L G
LG
Gaebel
W
W
Klosterkötter
J
J
Heuser
I
I
Kühn
K-U
KU
Lemke
M R
MR
Rüther
E
E
Klingberg
S
S
Gastpar
M
M
Bottlender
R
R
Möller
H-J
HJ
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
D014150:Antipsychotic Agents