title: Towards a framework for treatment effectiveness in schizophrenia.
abstract: BACKGROUND
  Prompt administration of antipsychotic treatment that is adhered to is essential for the optimal treatment of schizophrenia. Many patients have benefited from the advent of second-generation antipsychotics, which can offer good symptomatic control with reduced incidence of extrapyramidal symptoms, although with higher risk of metabolic side effects. It is unsurprising that accounts as to whether first- and second-generation antipsychotics differ in their efficacy vary, since treatment effectiveness is a broad notion and difficult to define.
  
  
  OBJECTIVE
  Numerous factors may be used to gauge treatment effectiveness and, while it has largely been defined in terms of improvements in four domains (symptoms of disease, treatment burden, disease burden, and health and wellness), the real-world clinical utility of this consensus is unclear. Therefore, this article aims to provide a framework that can aid psychiatrists in making assessments about treatment effectiveness.
  
  
  RESULTS
  A panel of 12 psychiatrists and psychopharmacologists convened to develop and propose an accessible and globally-applicable framework for assessing the effectiveness of antipsychotic treatments in patients with schizophrenia. Following presentation of a preliminary proposal to a wider group of psychiatrists from across Europe, it was refined into a framework comprising five domains: symptomatic remission and retention of treatment; affective symptoms; cognitive functioning; treatment satisfaction; and personal and social functioning - each of which is discussed in this article.
  
  
  CONCLUSIONS
  This article provides a framework that can aid psychiatrists in making assessments about treatment effectiveness. It is anticipated that the framework outlined here may contribute to improving clinical practice through the promotion of a patient-centered approach to the assessment of treatment effectiveness, using five specified domains, in patients with schizophrenia.
authors.affiliation: Department of Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Juckel
authors.affiliation: Laboratory of Molecular Psychiatry and Unit of Treatment Resistant Psychosis, University School of Medicine of Naples Federico II, Napoli, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: de Bartolomeis
authors.affiliation: Groupe Hospitalier Sainte-Anne (CMME), Paris-Descartes University, Paris, France.
authors.forename: Philip
authors.initials: P
authors.lastname: Gorwood
authors.affiliation: Moscow Research Institute of Psychiatry, Moscow, Russia.
authors.forename: Sergey
authors.initials: S
authors.lastname: Mosolov
authors.affiliation: Institute of Translational Pharmacology, Italian National Research Council, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pani
authors.affiliation: Università de L'Aquila, L'Aquila, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Clinic Hospital, Spanish Mental Health Network (CIBERSAM), University of Valencia, Valencia, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Sanjuan
keywords: antipsychotic; assessment scales; functioning; mental illness; satisfaction