title: Regional differences in treatment response and three year course of schizophrenia across the world.
abstract: Data from the Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO) study was used to determine the frequency of response and describe the course of disease in outpatients with schizophrenia in different regions of the world. The W-SOHO study was a 3-year, prospective, observational study that included over 17,000 outpatients with schizophrenia from 37 countries classified into six regions (Northern Europe, Southern Europe, Latin America, East Asia, Central & Eastern Europe, North Africa & Middle East). Cox proportional-hazards regression was employed to assess the factors associated with response. Multinomial logistic regression was used to assess the correlates of disease course. We found that approximately two-thirds of the patients (66.4%) achieved response during the 3-year follow up. Response rates varied across regions, and were highest in North Africa & Middle East (84.6%) and Latin America (78.6%) and lowest in Southern Europe (62.1%) and East Asia (60.9%). There were significant differences between the regions in the proportion of patients experiencing continuous remission, remission plus relapse and a persistent symptomatic course, and between the regions in the duration of remission. Overall, Latin America, East Asia, and North Africa & Middle East had more favorable outcomes because they had the largest proportion of people who achieved continuous remission, the longest time in remission and lowest percentage with a persistent symptomatic course. Having good social functioning at baseline was consistently associated with better clinical outcome. These results seem to indicate that patients from Latin America, East Asia, North Africa & Middle East may have a more favorable disease course than patients from European nations.
authors.affiliation: European Health Outcomes Research, Eli Lilly and Company, Lilly Research Centre, Erl Wood Manor, Windlesham, Surrey GU20 6PH, UK. Novick_diego@lilly.com
authors.forename: Diego
authors.initials: D
authors.lastname: Novick
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.forename: Jihyung
authors.initials: J
authors.lastname: Hong
authors.forename: Roberto
authors.initials: R
authors.lastname: Brugnoli
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Lepine
authors.forename: Jordan
authors.initials: J
authors.lastname: Bertsch
authors.forename: Jamie
authors.initials: J
authors.lastname: Karagianis
authors.forename: Martin
authors.initials: M
authors.lastname: Dossenbach
authors.forename: Enric
authors.initials: E
authors.lastname: Alvarez
mesh_terms: D000328:Adult; D005260:Female; D005843:Geography; D014943:Global Health; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010045:Outpatients; D012044:Regression Analysis; D012559:Schizophrenia / Q000453:epidemiology* / Q000628:therapy*