title: What are residual symptoms in schizophrenia spectrum disorder? Clinical description and 1-year persistence within a naturalistic trial.
abstract: The aim of this study was to evaluate residual symptoms in patients achieving remission according to the consensus criteria and to analyze their potential influence on the patient's outcome one year after discharge. In total, 399 patients suffering from a schizophrenia spectrum disorder were evaluated within a naturalistic study. Remission status was examined using the consensus criteria. Residual symptoms were defined as any symptom present at the time-point of remission following analogous analyses performed in depressed patients. Therefore, a PANSS item with a symptom severity of >1 (= at least borderline mentally ill) was defined to be a residual symptom. Remitters with and without residual symptoms were compared regarding psychopathology, functioning and side effects. In total, 236 patients (59%) were remitters at discharge with 94% of them suffering from at least one residual symptom. The most common residual symptoms were blunted affect (49%), conceptual disorganization (42%) and social withdrawal (40%). A significant association was found between the presence of residual symptoms and the severity of side effects (p < 0.0001) and functioning (p = 0.0003) at discharge as well as between residual symptoms and the risk of relapse and chance of remission one year after discharge. Residual symptoms were highly prevalent in remitted schizophrenia inpatients following the suggested definition. Most residual symptoms were persistent baseline symptoms suggesting an ongoing illness severity. Also, the necessity to re-evaluate the consensus criteria questioning the status of remission in these patients is also pointed out.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstrasse 7, 80336, Munich, Germany, Rebecca.Schennach@med.uni-muenchen.de.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Schennach
authors.forename: Michael
authors.initials: M
authors.lastname: Riedel
authors.forename: Michael
authors.initials: M
authors.lastname: Obermeier
authors.forename: Ilja
authors.initials: I
authors.lastname: Spellmann
authors.forename: Richard
authors.initials: R
authors.lastname: Musil
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
mesh_terms: D000328:Adult; D000704:Analysis of Variance; 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; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012008:Recurrence; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents