title: Decrease of functioning in remitted and non-remitted patients 16 years after a first-episode schizophrenia.
abstract: In schizophrenia, a better level of functioning has been generally associated with symptomatic remission. However, this association has been supported by cross-sectional studies or by studies with a short follow-up period. Forty-eight patients with schizophrenia were evaluated by the Positive and Negative Symptoms Scale and the Social and Occupational Functioning Assessment Scale (SOFAS) at the first episode and after a mean period of 16 years. At follow-up, patients were defined as remitters (R) or non-remitters (NR) according to the Remission Schizophrenia Working Group criteria. R (n = 18; 37.5%) compared to NR showed at the first episode a lower illness severity and a better level of functioning. A functional decline was found in both groups at follow-up, even though NR showed a more than twofold reduction than R. Better SOFAS scores at follow-up were predicted by baseline SOFAS score and less severe negative symptoms at follow-up. Schizophrenia implies a functional decline over time, regardless of the symptomatic remission status with negative symptoms playing a major role.
authors.affiliation: *Department of Neuroscience, Psychiatry Unit, University of Parma; and †Mental Health Department, Local Health Agency, Parma, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Marchesi
authors.forename: Andrea
authors.initials: A
authors.lastname: Affaticati
authors.forename: Alberto
authors.initials: A
authors.lastname: Monici
authors.forename: Chiara
authors.initials: C
authors.lastname: De Panfilis
authors.forename: Paolo
authors.initials: P
authors.lastname: Ossola
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ottoni
authors.forename: Matteo
authors.initials: M
authors.lastname: Tonna
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome