title: Rates and predictors of remission in first-episode schizophrenia within 1 year of antipsychotic maintenance treatment. Results of a randomized controlled trial within the German Research Network on Schizophrenia.
abstract: OBJECTIVE
  Full and sustained symptom remission is a major treatment objective after a first-episode in schizophrenia. Findings regarding differences in remission between first- and second-generation antipsychotics are inconclusive. This study aimed to provide rates and predictors of remission in first-episode schizophrenia and to identify symptoms that prevent remission.
  
  
  METHODS
  Prevalence rates of "symptomatic remission" (symptom criteria only) and "enduring remission" (symptom and 6-month time criteria), defined according to Andreasen et al. (2005), were determined in first-episode patients participating in a RCT by the German Research Network on Schizophrenia (GRNS) that compared post-acute, 1-year maintenance treatment with risperidone or haloperidol. Respective predictors at baseline were identified by logistic and Cox regression analysis.
  
  
  RESULTS
  Prevalence rates were 91.5% for symptomatic remission (n=152/166 eligible patients) and 58.6% for enduring remission (n=65 of 111 patients who continued for at least 6 months; 39.2% of all 166 patients included), with no significant differences between risperidone and haloperidol in either type of remission. Enduring remission often was not reached because of negative symptoms: After 6 months, 40.5% of the patients had at least 1 negative symptom, whereas only 10.8% of the patients had "persisting" positive symptoms. Of the different predictors identified in univariate analyses, (lower) negative symptoms and participating in standardized psychological treatment remained significant in multivariate (stepwise forward) analyses for enduring remission.
  
  
  CONCLUSIONS
  By far most of the first-episode patients reached a temporary state of full symptomatic remission within 1 year of antipsychotic treatment. However, only about 50% achieved sustained, enduring remission. Negative symptoms are still a major treatment obstacle to enduring remission in schizophrenia.
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany. Electronic address: wolfgang.gaebel@uni-duesseldorf.de.
authors: Wolfgang
authors: W
authors: Gaebel
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
authors: Mathias
authors: M
authors: Riesbeck
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
authors: Wolfgang
authors: W
authors: Wölwer
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany; Department of Psychiatry and Psychotherapy, Vitos Waldkrankenhaus Köppern, Germany.
authors: Ansgar
authors: A
authors: Klimke
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany; Department of Psychiatry, Westfalia Clinics, Warstein/Lippstadt, Germany.
authors: Matthias
authors: M
authors: Eickhoff
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
authors: Martina
authors: M
authors: von Wilmsdorff
authors: Department of Psychological Medicine, Charité-Campus Benjamin Franklin, Berlin, Germany.
authors: Isabella
authors: I
authors: Heuser
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Germany.
authors: Wolfgang
authors: W
authors: Maier
authors: Department of Psychiatry and Psychotherapy, University of Cologne, Germany.
authors: Joachim
authors: J
authors: Klosterkötter
authors: Department of Psychiatry and Psychotherapy, University of Göttingen, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
authors: Peter
authors: P
authors: Falkai
authors: Department of Psychiatry and Psychotherapy, University of Jena, Germany; AHG Römhild Clinic, Germany.
authors: Ralf
authors: R
authors: Schlösser
authors: Central Institute of Mental Health, Mannheim, University of Heidelberg, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
authors: Andrea
authors: A
authors: Schmitt
authors: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
authors: Michael
authors: M
authors: Riedel
authors: Department of Psychiatry and Psychotherapy, University of Tübingen, Germany.
authors: Stefan
authors: S
authors: Klingberg
authors: Department of Medical Informatics and Biomathematics, University of Münster, Germany.
authors: Wolfgang
authors: W
authors: Köpcke
authors: Coordinating Centre for Clinical Trials, Heinrich-Heine-University, Düsseldorf, Germany.
authors: Christian
authors: C
authors: Ohmann
authors: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
authors: Hans-Jürgen
authors: HJ
authors: Möller
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D035843:Biomedical Research / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*; D055502:Secondary Prevention
chemical_list: D014150:Antipsychotic Agents
keywords: 1-year remission rate–predictors–risperidone–haloperidol; First episode; Schizophrenia