Some Patients With Schizophrenia May Achieve Recovery With Effective Treatment

In a 3-year observation study of adults with schizophrenia (n=6642), the frequency and predictors of patient outcomes were assessed.^{[Novick et al., 2009]}

• The average age upon entry was 40.2 years (standard deviation=12.9 years), and mean duration of illness was 11.8 years (standard deviation=11.0 years).
• Long-lasting symptomatic remission was defined as achieving a level of severity that was mild or less (ie, a score of <4 on the scale from 1 to 7) in the CGI-SCH positive, negative, cognitive, and overall severity scores, plus no inpatient admission for a minimum period of 24 months maintained until the 36-month visit.
• 33% achieved long-lasting symptomatic remission.
• Long-lasting functional remission was defined as fulfilling the following 3 criteria for a minimum period of 24 months and maintaining until the 36-month visit: (1) a positive occupational/vocational status (ie, paid or unpaid full- or part-time employment, being an active student, or being a housewife); (2) living independently; and (3) having active social interactions (ie, having more than 1 social contact during the last 4 weeks or having a spouse or partner).
• 13% achieved long-lasting functional remission.
• Long-lasting adequate quality of life was defined as achieving an EQ-5D VAS score ≥70 for a minimum period of 24 months and maintaining it until the 36-month visit.
• 27% achieved long-lasting adequate quality of life.

Participants with first-episode psychosis (N=109) were recruited and followed for a mean of 10.5 years post-index admission to examine predictors of outcome.^{[White et al., 2009]}

• Poor outcomes were defined as fulfilling all of the following criteria: mentally ill in the last year; mentally ill for at least 5 of the previous 10 years; employed for less than 2 of the last 10 years; and did not work at all in the last year. The criteria were broadened to also include participants who died from an unnatural cause of death.
• A total of 64 out of 103 (62%) patients at the end of the trial were rated as having a poor outcome based on these criteria.

References:
Novick D, Haro JM, Suarez D, Vieta E, Naber D. Recovery in the outpatient setting: 36-month results from the Schizophrenia Outpatients Health Outcomes (SOHO) study. Schizophr Res. 2009; 108 (1-3): 223-230.

White C, Stirling J, Hopkins R, et al. Predictors of 10-year outcome of first-episode psychosis. Psychol Med. 2009; 39 (9): 1447-1456.