Time course of antipsychotic treatment response in schizophrenia: Results from a naturalistic study in 280 patients

Jäger, M.; Riedel, M.; Obermeier, M.; Schennach-Wolff, R.; Seemüller, F.; Messer, T.; Laux, G.; Pfeiffer, H.; Naber, D.; Schmidt, L.G.; Gaebel, W.; Klosterkötter, J.; Heuser, I.; Kühn, K.-U; Lemke, M.R.; Rüther, E.; Klingberg, S.; Gastpar, M.; Bottlender, R.; Möller, H.-J.

doi:10.1016/j.schres.2010.02.002

« Previous Next »Schizophrenia Research
Volume 118, Issue 1 , Pages 183-188, May 2010

Time course of antipsychotic treatment response in schizophrenia: Results from a naturalistic study in 280 patients

M. Jäger
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany
- Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, D-89312 Günzburg, Germany
- Corresponding author. Department of Psychiatry II, Ulm University, BKH Günzburg Ludwig-Heilmeyer-Str. 2, D-89312 Günzburg, Germany. Tel.: +49 8221 96 2204; fax: +49 8221 96 2737.
M. Riedel
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany
M. Obermeier
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany
R. Schennach-Wolff
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany
F. Seemüller
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany
T. Messer
- Psychiatric Clinic, District Hospital Augsburg, Dr. Mack-Str. 1, D-86156 Augsburg, Germany
G. Laux
- Psychiatric Clinic, Inn-Salzach Hospital, Gabersee 7, 83512 Wasserburg/Inn, Germany
H. Pfeiffer
- Psychiatric Clinic, Isar-Amper Hospital, Munich-East, Vockestr. 73, D-85540 Haar, Germany
D. Naber
- Department of Psychiatry, University of Hamburg, Martinistr. 52, D-20246 Hamburg, Germany
L.G. Schmidt
- Department of Psychiatry, Johannes-Gutenberg University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
W. Gaebel
- Department of Psychiatry, Heinrich-Heine-University Düsseldorf, Bergische Landstr. 2, D-40629 Düsseldorf, Germany
J. Klosterkötter
- Department of Psychiatry, University of Cologne, Kerpener Str. 62, D-50924 Cologne, Germany
I. Heuser
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Chariteplatz 1, D-10117 Berlin, Germany
K.-U Kühn
- Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 27, D-53105 Bonn, Germany
M.R. Lemke
- Psychiatric Clinic, Alsterdorf Hospital, Alsterdorfer Markt, D-22297 Hamburg, Germany
E. Rüther
- Department of Psychiatry, University of Göttingen, von Siebold Str. 5, D-37075 Göttingen, Germany
S. Klingberg
- Department of Psychiatry, University of Tübingen, Osianderstr. 24, D-72076 Tübingen, Germany
M. Gastpar
- Department of Psychiatry, University of Essen, Virchowstr. 174, D-45147 Essen, Germany
R. Bottlender
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany
H.-J. Möller
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany

Received 19 November 2009; received in revised form 29 January 2010; accepted 2 February 2010. published online 25 February 2010.

Abstract

Objective

To describe the course of positive and negative symptoms during inpatient treatment and examine remission and response rates under routine clinical care conditions.

Methods

Two hundred and eighty inpatients with schizophrenia (DSM-IV criteria) were assessed with the Positive and Negative Syndrome Scale (PANSS) at admission and at biweekly intervals until discharge from hospital. Remission was defined according to the symptom–severity component of the consensus criteria (Remission in Schizophrenia Working Group) as a rating of three or less in the relevant PANSS items at discharge, and response as a reduction of at least 20% in the PANSS total score from admission to discharge.

Results

The mean duration of inpatient treatment was 54.8days. Of the total sample, 78.5% achieved the criteria for response and 44.6% those for remission. Mean PANSS total scores decreased from 72.4 at admission to 52.5 at discharge (p<0.001). A reduction in PANSS total scores was found from visit to visit, up to week 8. The most pronounced decline was observed within the first two weeks of treatment.

Conclusion

Response rates were comparable to those found in efficacy studies, and remission rates were slightly higher. This may be explained by differences in the selection and the treatment of patients. Nevertheless, the findings might indicate that a complex naturalistic treatment approach is beneficial in terms of effectiveness.

Keywords: Schizophrenia, Treatment, Remission, Response