title: Trajectories of antipsychotic response in drug-naive schizophrenia patients: results from the 6-month ESPASS follow-up study.
abstract: OBJECTIVE
  The aim of this study was to explore any heterogeneity in the 6-month clinical response in patients with antipsychotic drug-naive schizophrenia and to determine predictors of that outcome.
  
  
  METHODS
  467 patients with antipsychotic drug-naive schizophrenia were included in France nationwide and followed up over 6 months. To identify trajectories of clinical response, a latent class growth analysis (LCGA) was performed using the Clinical Global Impression-Severity (CGI-S) scores at baseline, 1, 3, and 6 months. Regression models were used to identify predictors of trajectory membership.
  
  
  RESULTS
  Five trajectory groups were identified: a rapid response group (n = 45), a gradual response group (n = 204), patients remaining mildly ill (n = 133), patients remaining very ill (n = 23), and a group with unsustained clinical response (n = 62). Predictors of the 6-month clinical response were baseline CGI-S score (odds ratio: 3.1; 95% confidence interval, 2.1-4.4) and negative symptoms (OR, 1.5; 95% CI, 1.2-1.9). The sole predictor of rapid response as compared to gradual response was employment (OR, 2.5; 95% CI, 1.2-4.9).
  
  
  CONCLUSIONS
  Clinical response in patients with schizophrenia 6 months after a first-ever antipsychotic drug initiation is heterogeneous. Therapeutic strategies in first episode should take account of symptom severity and early clinical response, to maximize the chances of recovery.
authors.affiliation: INSERM 669, Paris-Sud University and Paris-Descartes University, Paris, France; Clinique des Maladies Mentales et de l'Encéphale, Sainte Anne Hospital Center, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Nordon
authors.forename: F
authors.initials: F
authors.lastname: Rouillon
authors.forename: J M
authors.initials: JM
authors.lastname: Azorin
authors.forename: C
authors.initials: C
authors.lastname: Barry
authors.forename: M
authors.initials: M
authors.lastname: Urbach
authors.forename: B
authors.initials: B
authors.lastname: Falissard
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012559:Schizophrenia / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: antipsychotic agents; drug response; heterogeneity; schizophrenia; trajectories