An early improvement threshold to predict response and remission in first-episode schizophrenia.
BACKGROUND
Early improvement with treatment is thought to be important in patients with first-episode schizophrenia, yet a valid definition is still outstanding.


OBJECTIVE
To develop a valid definition of early improvement and test its predictive validity regarding response and remission.


METHODS
We examined 188 in-patients with first-episode schizophrenia. Early improvement was defined as improvement in Positive and Negative Syndrome Scale (PANSS) total score at week 2, response as a 40% PANSS total score improvement at end-point, and remission according to consensus criteria.


RESULTS
Reasonable predictive validity of early improvement was found for a 46% PANSS total score improvement at week 2 and a 50% improvement for remission (area under the curve: response 0.707, remission 0.692). Estimated confidence intervals ranged from 26 to 62% PANSS reduction for response and remission.


CONCLUSIONS
Patients with a first episode of schizophrenia should improve by at least 30% in PANSS total score at week 2 to achieve response and remission.
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstrasse 7, Muenchen 80336, Germany. rebecca.schennach-wolff@med.uni-muenchen.de
Rebecca
R
Schennach-Wolff
Florian Hannes
FH
Seemüller
Andreas
A
Mayr
Wolfgang
W
Maier
Stefan
S
Klingberg
Isabella
I
Heuser
Joachim
J
Klosterkötter
Markus
M
Gastpar
Heinz
H
Häfner
Heinrich
H
Sauer
Frank
F
Schneider
Wolfgang
W
Gaebel
Markus
M
Jäger
Hans-Jürgen
HJ
Möller
Michael
M
Riedel
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005858:Germany; D006220:Haloperidol / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy*; D012372:ROC Curve; D012074:Remission Induction / Q000379:methods; D018967:Risperidone / Q000008:administration & dosage; D012559:Schizophrenia / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D014150:Antipsychotic Agents; D006220:Haloperidol; D018967:Risperidone