title: The relationship between Positive and Negative Syndrome Scale (PANSS) schizophrenia severity scores and risk for hospitalization: an analysis of the CATIE Schizophrenia Trial.
abstract: BACKGROUND
  Little is known about the effect of treatment-related changes in Positive and Negative Syndrome Scale (PANSS) schizophrenia severity scores on the risk for subsequent hospitalization.
  
  
  METHODS
  We used limited-access data from the Clinical Antipsychotic Trials of Intervention Effectiveness Project Schizophrenia Trial (CATIE Sz) to evaluate the relationship between baseline and changes in PANSS clinical symptom scores and risks for subsequent psychiatric hospitalization.
  
  
  RESULTS
  Reductions in PANSS total scores during a three-month period were associated with a significantly lower risk for psychiatric hospitalization (OR, 0.78, 95% CI, 0.72 to 0.84, p<0.001 for 10 point reductions). Ten-point reductions in PANSS total score during three months reduced predicted number of psychiatric hospitalizations by 0.02 (95% CI, 0.012 to 0.027) and nights in the hospital by 0.24 (95% CI, 0.07 to 0.41). Maintenance of this reduction for a year is expected to reduce psychiatric hospitalizations by 0.10 (95% CI, 0.08 to 0.13) and nights hospitalized by 1.4 (95% CI, 0.9 to 1.9). A 10-point reduction in PANSS total score was associated with a savings in psychiatric hospitalization cost of $192 over three months and $1135 over a year.
  
  
  CONCLUSIONS
  Reductions in PANSS total scores significantly reduced risks for psychiatric hospitalizations, total number of psychiatric hospitalizations, total nights for psychiatric admissions, and the costs of these hospitalizations. These data highlight the benefits of symptom control on the direct costs of care in schizophrenia.
authors.affiliation: Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Room 1211 Blockley Hall, Philadelphia, PA 19104, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, 423 Guardian Drive, Room 1211 Blockley Hall, Philadelphia, PA 19104, USA. Electronic address: hlthsvrs@mail.med.upenn.edu.
authors.forename: Henry A
authors.initials: HA
authors.lastname: Glick
authors.affiliation: Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Room 1213 Blockley Hall, Philadelphia, PA 19104, USA. Electronic address: penli@mail.med.upenn.edu.
authors.forename: Pengxiang
authors.initials: P
authors.lastname: Li
authors.affiliation: University of Miami Miller School of Medicine Research Service, Bruce W. Carter VA Medical Center, Clinical Research Building, 1120 NW 14th St, 14th flr, Miami, FL 33136, USA. Electronic address: pharvey@med.miami.edu.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Harvey
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012306:Risk; D012559:Schizophrenia / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index
chemical_list: D014150:Antipsychotic Agents
keywords: CATIE Sz; Hospitalization; Psychiatric Status Rating Scales; Schizophrenia