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Remission in schizophrenia: results of cross-sectional with 6-month follow-up period and 1-year observational therapeutic studies in an outpatient population.

Mosolov SN, Potapov AV, Ushakov UV - Ann Gen Psychiatry (2012)

Bottom Line: Patients who were stable but did not satisfied the symptomatic criteria were included in a further 1-year observational study, with the first group (first district) receiving risperidone (long-acting, injectable) (RLAI) and the second group (second district) continuing to receiving routine treatment.Furthermore, reduction of PANSS total and subscale scores, as well as improvement in social functioning, was more significant in the first group.Use of RLAI gave a better remission rate than achieved in standard care with routine treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department for Treatment of Mental Disorders, Moscow Research Institute of Psychiatry, Moscow, Russia. profmosolov@mtu-net.ru.

ABSTRACT

Background: A standardized definition of remission criteria in schizophrenia was proposed by the International group of NC Andreasen in 2005 (low symptom threshold for the eight core Positive and Negative Syndrome Scale (PANSS) symptoms for at least 6 consecutive months).

Methods: A cross-sectional study of remission rate, using a 6-month follow-up to assess symptomatic stability, was conducted in two healthcare districts (first and second) of an outpatient psychiatric service in Moscow. The key inclusion criteria were outpatients with an International Classification of Diseases, 10th edition (ICD-10) diagnosis of schizophrenia or schizoaffective disorder. Remission was assessed using modern criteria (severity and time criteria), PANSS and Global Assessment of Functioning (GAF). Patients who were stable but did not satisfied the symptomatic criteria were included in a further 1-year observational study, with the first group (first district) receiving risperidone (long-acting, injectable) (RLAI) and the second group (second district) continuing to receiving routine treatment. Symptoms were assessed with PANSS, social functioning with the personal and social performance scale, compliance with rating of medication influences scale, and extrapyramidal side effects with the Simpson-Angus scale.

Results: Only 64 (31.5%) of 203 outpatients met the criteria for symptomatic remission in the cross-sectional study, but at the end of the 6-month follow-up period, 158 (77.8%) were stable (irrespective of remission status). Among these only 53 (26.1%) patients fulfilled the remission criteria. The observational study had 42 stable patients in the RLAI group and 35 in the routine treatment group: 19.0% in the RLAI group and 5.7% in the control group met remission criteria after 12 months of therapy. Furthermore, reduction of PANSS total and subscale scores, as well as improvement in social functioning, was more significant in the first group.

Conclusions: Only around one-quarter of our outpatient schizophrenic population met full remission criteria. Use of RLAI gave a better remission rate than achieved in standard care with routine treatment. Criteria for remission should take into account clinical course and functioning to support clinical care.

No MeSH data available.


Related in: MedlinePlus

Remission rates at the end point (12 months) in the risperidone (long-acting, injectable) (RLAI) and control groups (last observation carried forward used for missing data).
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Figure 1: Remission rates at the end point (12 months) in the risperidone (long-acting, injectable) (RLAI) and control groups (last observation carried forward used for missing data).

Mentions: The symptomatic criterion in the RLAI group was met by 16.7% of patients at month 3, 23.8% at month 6 and 21.4% at month 12 (Friedman ANOVA, P < 0.0001). However, only 19% of patients met both the symptom and duration criteria (Friedman ANOVA, P < 0.0001). In the routine treatment group, only 5.7% of subjects achieved full remission at month 12 (Friedman ANOVA, P = 0.03). Starting from month 3, there was a significant difference between the groups (Mann-Whitney, P < 0.05) that continued to months 6 and 12 (Mann-Whitney, P < 0.0001) (Figure 1).


Remission in schizophrenia: results of cross-sectional with 6-month follow-up period and 1-year observational therapeutic studies in an outpatient population.

Mosolov SN, Potapov AV, Ushakov UV - Ann Gen Psychiatry (2012)

Remission rates at the end point (12 months) in the risperidone (long-acting, injectable) (RLAI) and control groups (last observation carried forward used for missing data).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3278338&req=5

Figure 1: Remission rates at the end point (12 months) in the risperidone (long-acting, injectable) (RLAI) and control groups (last observation carried forward used for missing data).
Mentions: The symptomatic criterion in the RLAI group was met by 16.7% of patients at month 3, 23.8% at month 6 and 21.4% at month 12 (Friedman ANOVA, P < 0.0001). However, only 19% of patients met both the symptom and duration criteria (Friedman ANOVA, P < 0.0001). In the routine treatment group, only 5.7% of subjects achieved full remission at month 12 (Friedman ANOVA, P = 0.03). Starting from month 3, there was a significant difference between the groups (Mann-Whitney, P < 0.05) that continued to months 6 and 12 (Mann-Whitney, P < 0.0001) (Figure 1).

Bottom Line: Patients who were stable but did not satisfied the symptomatic criteria were included in a further 1-year observational study, with the first group (first district) receiving risperidone (long-acting, injectable) (RLAI) and the second group (second district) continuing to receiving routine treatment.Furthermore, reduction of PANSS total and subscale scores, as well as improvement in social functioning, was more significant in the first group.Use of RLAI gave a better remission rate than achieved in standard care with routine treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department for Treatment of Mental Disorders, Moscow Research Institute of Psychiatry, Moscow, Russia. profmosolov@mtu-net.ru.

ABSTRACT

Background: A standardized definition of remission criteria in schizophrenia was proposed by the International group of NC Andreasen in 2005 (low symptom threshold for the eight core Positive and Negative Syndrome Scale (PANSS) symptoms for at least 6 consecutive months).

Methods: A cross-sectional study of remission rate, using a 6-month follow-up to assess symptomatic stability, was conducted in two healthcare districts (first and second) of an outpatient psychiatric service in Moscow. The key inclusion criteria were outpatients with an International Classification of Diseases, 10th edition (ICD-10) diagnosis of schizophrenia or schizoaffective disorder. Remission was assessed using modern criteria (severity and time criteria), PANSS and Global Assessment of Functioning (GAF). Patients who were stable but did not satisfied the symptomatic criteria were included in a further 1-year observational study, with the first group (first district) receiving risperidone (long-acting, injectable) (RLAI) and the second group (second district) continuing to receiving routine treatment. Symptoms were assessed with PANSS, social functioning with the personal and social performance scale, compliance with rating of medication influences scale, and extrapyramidal side effects with the Simpson-Angus scale.

Results: Only 64 (31.5%) of 203 outpatients met the criteria for symptomatic remission in the cross-sectional study, but at the end of the 6-month follow-up period, 158 (77.8%) were stable (irrespective of remission status). Among these only 53 (26.1%) patients fulfilled the remission criteria. The observational study had 42 stable patients in the RLAI group and 35 in the routine treatment group: 19.0% in the RLAI group and 5.7% in the control group met remission criteria after 12 months of therapy. Furthermore, reduction of PANSS total and subscale scores, as well as improvement in social functioning, was more significant in the first group.

Conclusions: Only around one-quarter of our outpatient schizophrenic population met full remission criteria. Use of RLAI gave a better remission rate than achieved in standard care with routine treatment. Criteria for remission should take into account clinical course and functioning to support clinical care.

No MeSH data available.


Related in: MedlinePlus