title: Influencing factors and predictors of early improvement in the acute treatment of schizophrenia and schizophrenia spectrum disorder.
abstract: BACKGROUND
  To examine the influencing factors and predictors of early improvement in schizophrenia patients.
  
  
  METHODS
  370 patients suffering from a schizophrenia spectrum disorder were examined within a naturalistic multicenter study. Early improvement was defined as a ≥30% PANSS total score reduction within the first two treatment weeks, response as a ≥50% improvement of the PANSS total score from admission to discharge and remission according to the consensus remission criteria. Baseline and course-related variables such as positive, negative and depressive symptoms, side effects, functioning and subjective well-being were examined regarding their explanatory value for early improvement.
  
  
  RESULTS
  46% of the patients were identified to be early improvers. Of these, 77% became treatment responder at discharge and 74% achieved the consensus remission criteria. Amongst others, early improvers were significantly more often first-episode patients (p = 0.009), with a significantly shorter duration of current episode (p = 0.024) and a shorter duration of the illness (p = 0.0094). A higher PANSS positive subscore (p = 0.0089), a higher score in the Strauss-Carpenter-Prognostic Scale (SCPS) (p < 0.0001), less extrapyramidal side effects (p = 0.0004) at admission and the development of less extrapyramidal side effects within the first two treatment weeks (p = 0.0013) as well as a duration of current episode of ≤6 months (p = 0.0373) were identified to be significant predictors of early improvement.
  
  
  CONCLUSIONS
  Early improvement is associated with less illness chronicity and seems to be independent of the type of antipsychotic and the antipsychotic dosage applied. The SCPS was found to be a valuable tool to detect early improvers already at the initiation of antipsychotic treatment.
authors.affiliation: Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, 80336 Munich, Germany. Rebecca.Schennach-Wolff@med.uni-muenchen.de
authors.forename: Rebecca
authors.initials: R
authors.lastname: Schennach-Wolff
authors.forename: Sebastian
authors.initials: S
authors.lastname: Meyer
authors.forename: Florian
authors.initials: F
authors.lastname: Seemüller
authors.forename: Markus
authors.initials: M
authors.lastname: Jäger
authors.forename: Max
authors.initials: M
authors.lastname: Schmauss
authors.forename: Gerd
authors.initials: G
authors.lastname: Laux
authors.forename: Herbert
authors.initials: H
authors.lastname: Pfeiffer
authors.forename: Dieter
authors.initials: D
authors.lastname: Naber
authors.forename: Lutz G
authors.initials: LG
authors.lastname: Schmidt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.forename: Joachim
authors.initials: J
authors.lastname: Klosterkötter
authors.forename: Isabella
authors.initials: I
authors.lastname: Heuser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Matthias R
authors.initials: MR
authors.lastname: Lemke
authors.forename: Eckart
authors.initials: E
authors.lastname: Rüther
authors.forename: Stefan
authors.initials: S
authors.lastname: Klingberg
authors.forename: Markus
authors.initials: M
authors.lastname: Gastpar
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Michael
authors.initials: M
authors.lastname: Riedel
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents