Clinical and psychosocial remission in schizophrenia: correlations with antipsychotic treatment

Yoram Barak,Dov Aizenberg

doi:10.1186/1471-244x-12-108

Abstract

BackgroundClinical and psychosocial remission amongst persons with schizophrenia is nowadays a defined goal of treatment. This necessitates incorporating quantifiable psychosocial variables with traditional symptomatic data. We aimed to assess clinical and psychosocial remission in schizophrenia in a large cohort of community dwelling persons with schizophrenia. We emphasized between-groups comparison of antipsychotic medications and administration methods on the outcome of remission.MethodsPsychiatric case managers rated psychosocial remission using the PsychoSocial Remission Scale (PSRS) and clinical remission using the Remission in Schizophrenia Working Group symptomatic remission criteria (RSWG). Ratings were performed for persons with schizophrenia they have been treating for 6 months or more. Data as to gender, age and pharmacological treatment of each patient were also collected.ResultsOf 445 participants who completed the survey, 268 (60%) were evaluated by psychiatrists, 161 (36%) by nurses and 16 (4%) were evaluated by social workers. Patients mean age was 43.4 + 13.1 years; 61% were men and 39% were women. Antipsychotic treatments were as follows: Per-os (PO) 243 (55%), IM long-acting typical antipsychotics (LAT) 102 (23%) and IM long-acting risperidone (RLAI; Consta) 100 (22%). Overall, 37% of patients achieved symptomatic remission and 31% achieved psychosocial remission. Rates of symptomatic remission were significantly higher in patients treated by LAT and RLAI compared with PO (51% and 48% vs., 29% respectively, p = 0.0003). Rates of psychosocial remission were also significantly higher in patients treated by LAT and RLAI compared with PO (43%% and 41% vs., 24% respectively, p = 0.003).ConclusionIn a large national sample a third of persons with schizophrenia were in remission. IM long acting preparations were associated with higher remission rates. Treatment choice may thus influence rates of remission in persons with schizophrenia.

Highlights

Clinical and psychosocial remission amongst persons with schizophrenia is nowadays a defined goal of treatment
Rates of symptomatic remission were significantly higher in patients treated by Intra Muscular (IM) long acting first generation antipsychotic medications and IM long acting risperidone compared with oral medications (51% and 48% vs., 29% respectively, p = 0.0003)
Psychosocial remission rates were found to be lower than symptomatic remission underlining the need to address this issue through a variety of interventions

Summary

Introduction

Clinical and psychosocial remission amongst persons with schizophrenia is nowadays a defined goal of treatment. This necessitates incorporating quantifiable psychosocial variables with traditional symptomatic data. Consensus-defined standards for symptomatic remission in persons with schizophrenia have been the focus of clinical and research interest in the last decade [2]. Such standards provide clarity for treatment goals, as well as a framework for the design and comparison of investigational trials and the assessment of the effectiveness of pharmacological and psychosocial interventions. Psychosocial function and dysfunction are of critical importance in achieving remission yet there is still a scarcity of studies addressing this issue using formal quantifiable rating scales

Objectives

Results

Discussion

Conclusion