title: Understanding the impact of persistent symptoms in schizophrenia: Cross-sectional findings from the Pattern study.
abstract: BACKGROUND
  The high societal burden of schizophrenia is largely caused by the persistence of symptoms and accompanying functional impairment. To date, no studies have specifically assessed the course of persistent symptoms or the individual contributions of positive and negative symptoms to patient functioning. The cross-sectional analysis of the Pattern study provides an international perspective of the burden of schizophrenia.
  
  
  METHODS
  Clinically stable outpatients from 140 study centers across eight countries (Argentina, Brazil, Canada, France, Germany, Italy, Spain and the United Kingdom) were assessed using clinical rating scales: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Schizophrenia (CGI-SCH) Scale and the Personal and Social Performance (PSP) Scale. Additional measures included patient-reported outcomes, patient socio-demographic variables, living situation, employment and resource use.
  
  
  RESULTS
  Overall, 1379 patients were assessed and analyzed and had similar sociodemographic characteristics across countries, with 61.6% having persistent positive and/or negative symptoms. Positive and negative symptoms had been persistent for a mean of 9.6 and 8.9 years (SD: 8.8 and 9.6), respectively. Approximately 86% of patients had a functional disability classified as greater than mild. Patients with a higher PANSS Negative Symptom Factor Score were more likely to have a poorer level of functioning.
  
  
  CONCLUSIONS
  This analysis examines individual contributions of persistent positive and negative symptoms on patient functioning in different countries. A high prevalence of patients with persistent symptoms and functional impairment was a consistent finding across countries. Longitudinal observations are necessary to assess how to improve persistent symptoms of schizophrenia and overall patient functioning.
authors.affiliation: Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain. Electronic address: 27652jha@comb.cat.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.affiliation: University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milano, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Altamura
authors.affiliation: Fundación para el Estudio y Tratamiento de las Enfermedades Mentales (FETEM), Cerviño 4634 5th floor Apt. B, Buenos Aires C1425AHQ, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Corral
authors.affiliation: Departamento e Instituto de Psiquiatria-FMUSP, Sao Paulo, Brazil.
authors.forename: Helio
authors.initials: H
authors.lastname: Elkis
authors.affiliation: Centre for Academic Mental Health, University of Bristol, Bristol BS8 2BN, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Evans
authors.affiliation: Douglas Mental Health University Institute, McGill University, Montréal, Qc H4H 1R3, Canada.
authors.forename: Ashok
authors.initials: A
authors.lastname: Malla
authors.affiliation: Service Hospitalo Universitaire, Laboratoire de Physiopathologie des Maladies Psychiatriques, Inserm, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Krebs
authors.affiliation: Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Zink
authors.affiliation: F. Hoffmann-La Roche Ltd, Basel, Switzerland.
authors.forename: Corrado
authors.initials: C
authors.lastname: Bernasconi
authors.affiliation: F. Hoffmann-La Roche Ltd, Basel, Switzerland.
authors.forename: Justine
authors.initials: J
authors.lastname: Lalonde
authors.affiliation: F. Hoffmann-La Roche Ltd, Basel, Switzerland.
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Nordstroem
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index
keywords: Epidemiology; Functional impairment; Persistent negative symptoms; Persistent positive symptoms; Quality of life; Schizophrenia