Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-25T18:40:56.386Z Has data issue: false hasContentIssue false
  • English
  • Français

Remitted but still impaired? Symptomatic versus functional remission in patients with schizophrenia

Published online by Cambridge University Press:  15 April 2020

A. Karow ,
S. Moritz ,
M. Lambert ,
D. Schöttle ,
D. Naber  and
on behalf of the EGOFORS initiative
A. Karow*
Affiliation:
Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
S. Moritz
Affiliation:
Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
M. Lambert
Affiliation:
Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
D. Schöttle
Affiliation:
Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
D. Naber
Affiliation:
Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
*
*Corresponding author. Tel.: +49 40 7410 57384; fax: +49 40 7410 55455. E-mail address: karow@uke.de (A. Karow).
Get access

Abstract

Introduction

Studies reported close associations between functional outcome and symptomatic remission as defined by the Remission in Schizophrenia Working Group. This observational study was aimed at the investigation of deficits in daily functioning, symptoms and subjective well-being in remitted and non-remitted patients with schizophrenia.

Methods

Symptoms (PANSS), functional outcome (FROGS, GAF), subjective well-being (SWN-K) and other characteristics were assessed in 131 patients with schizophrenia (DSM-IV) within the European Group on Functional Outcomes and Remission in Schizophrenia (EGOFORS) project.

Results

A significant better level of functioning was measured for remitted versus non-remitted patients, though remitted patients still showed areas with an inadequate level of functioning. Functional deficits were most often seen in social relations (40%), work (29%) and daily life activities (17%). Best functioning was assessed for self-care, self-control, health management and medical treatment. A moderate to severe level of disorganization and emotional distress was observed in 38% and impaired subjective well-being in 29% of patients defined as being in symptomatic remission.

Discussion

The results confirm a close association between symptomatic remission and functional outcome. However, deficits in different areas of functioning, symptoms and well-being underline the need for combined outcome criteria for patients with schizophrenia.

Keywords

SchizophreniaRemissionRecoveryFunctional outcomeSubjective well-being
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 6 , August 2012 , pp. 401 - 405
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Denotes equal contribution.

References

Andreasen, N.C., Carpenter, W.T. Jr.Kane, J.M.et al.Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005; 162: 441–449.CrossRefGoogle ScholarPubMed
APA, Diagnostic and statistical manual of mental disorders. 4th ed.Washington DC: American Psychiatric Press; 1994.Google Scholar
Bell, M.D., Lysaker, P.H., Beam-Goulet, J.L., Milstein, R.M., Lindenmayer, J.P.Five-component model of schizophrenia: assessing the factorial invariance of the positive and negative syndrome scale. Psychiatry Res. 1994; 52: 295–303.CrossRefGoogle ScholarPubMed
Bobes, J., Ciudad, A., Alvarez, E.et al.Recovery from schizophrenia: results from a 1-year follow-up observational study of patients in symptomatic remission. Schizophrenia Res. 2009; 115: 58–66.CrossRefGoogle ScholarPubMed
Boden, R., Sundstrom, J., Lindstrom, E., Lindstrom, L.Association between symptomatic remission and functional outcome in first-episode schizophrenia. Schizophrenia Res. 2009; 107: 232–237.CrossRefGoogle ScholarPubMed
Cohen, C.I., Pathak, R., Ramirez, P.M., Vahia, I.Outcome among community dwelling older adults with schizophrenia: results using five conceptual models. Community Ment Health J. 2009; 45: 151–156.CrossRefGoogle ScholarPubMed
DeHaan, L., Weisfelt, M., Dingemans, P.M.et al.Psychometric properties of the Subjective Well-Being Under Neuroleptics scale and the Subjective Deficit Syndrome Scale. Psychopharmacology. 2002; 162: 24–28.CrossRefGoogle Scholar
Green, M.F., Kern, R.S., Braff, D.L., Mintz, J.Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophr Bull. 2000; 26: 119–136.CrossRefGoogle ScholarPubMed
Hafner, H.Schizophrenia and depression. Eur Arch Psychiatry Clin Neurosci. 2005; 255: 157–158.CrossRefGoogle ScholarPubMed
Helldin, L., Kane, J.M., Karilampi, U., Norlander, T., Archer, T.Remission in prognosis of functional outcome: a new dimension in the treatment of patients with psychotic disorders. Schizophr Res. 2007; 93: 160–168.CrossRefGoogle ScholarPubMed
Karow, A., Czekalla, J., Dittmann, R.W.et al.Association of subjective well-being, symptoms, and side effects with compliance after 12months of treatment in schizophrenia. J Clin Psychiatry. 2007; 68: 75–80.CrossRefGoogle Scholar
Kay, S.R., Fiszbein, A., Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13: 261–276.CrossRefGoogle Scholar
Lambert, M., De Marinis, T., Pfeil, J., Naber, D., Schreiner, A.Establishing remission and good clinical functioning in schizophrenia: Predictors of best outcome with long-term risperidone long-acting injectable treatment. Eur Psychiatry. 2009.Google ScholarPubMed
Lambert, M., Naber, D., Schacht, A.et al.Rates and predictors of remission and recovery during 3years in 392 never-treated patients with schizophrenia. Acta Psychiatr Scand. 2008; 118: 220–229.CrossRefGoogle Scholar
Lambert, M., Schimmelmann, B.G., Karow, A., Naber, D.Subjective well-being and initial dysphoric reaction under antipsychotic drugs - concepts, measurement and clinical relevance. Pharmacopsychiatry. 36 Suppl3 2003 S181–S190.Google ScholarPubMed
Lambert, M., Schimmelmann, B.G., Naber, D.et al.Early- and delayed antipsychotic response and prediction of outcome in 528 severely impaired patients with schizophrenia treated with amisulpride. Pharmacopsychiatry. 2009; 42: 277–283.CrossRefGoogle ScholarPubMed
Lambert, M., Schimmelmann, B.G., Naber, D.et al.Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry. 2006; 67: 1690–1697.CrossRefGoogle ScholarPubMed
Leucht, S., Lasser, R.The concepts of remission and recovery in schizophrenia. Pharmacopsychiatry. 2006; 39: 161–170.CrossRefGoogle Scholar
Llorca, P.M., Lancon, C., Lancrenon, S.et al.The “Functional Remission of General Schizophrenia” (FROGS) scale: development and validation of a new questionnaire. Schizophr Res. 2009; 113: 218–225.CrossRefGoogle ScholarPubMed
Naber, D.A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol. 10 Suppl 3 1995 133–138.Google ScholarPubMed
Naber, D., Moritz, S., Lambert, M.et al.Improvement of schizophrenic patients; subjective well-being under atypical antipsychotic drugs. Schizophr Res. 50 1–2: 2001 79–88.CrossRefGoogle ScholarPubMed
Schennach-Wolff, R., Jager, M., Seemuller, F.et al.Defining and predicting functional outcome in schizophrenia and schizophrenia spectrum disorders. Schizophr Res. 2009; 113: 210–217.CrossRefGoogle ScholarPubMed
van der Gaag, M., Cuijpers, A., Hoffman, T.et al.The five-factor model of the Positive and Negative Syndrome Scale I: confirmatory factor analysis fails to confirm 25 published five-factor solutions. Schizophr Res. 2006; 85: 273–279.CrossRefGoogle ScholarPubMed
van Os, J., Burns, T., Cavallaro, R.et al.Standardized remission criteria in schizophrenia. Acta Psychiatr Scand. 2006; 113: 91–95.Google Scholar
Warner, R.Recovery from schizophrenia and the recovery model. Curr Opin Psychiatry. 2009; 22: 374–380.CrossRefGoogle ScholarPubMed
Wunderink, L., Nienhuis, F.J., Sytema, S., Wiersma, D.Predictive validity of proposed remission criteria in first-episode schizophrenic patients responding to antipsychotics. Schizophr Bull. 2007; 33: 792–796.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.