Treatment resistance in schizophrenia: a meta-analysis of prevalence and correlates
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
;
45(5): 448-458, Sept.-Oct. 2023. tab, graf
Article
Dans Anglais
|
LILACS-Express
| LILACS
| ID: biblio-1528002
ABSTRACT
Objectives:
To determine the prevalence and correlates of treatment-resistant schizophrenia (TRS) through a systematic review and meta-analysis.Methods:
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, an electronic search was performed in PubMed and Embase through May 17, 2022. All study designs that assessed a minimum of 20 schizophrenia-spectrum patients and provided data on TRS prevalence or allowed its calculation were included. Estimates were produced using a random-effects model meta-analysis.Results:
The TRS prevalence across 50 studies (n = 29,390) was 36.7% (95%CI 33.1-40.5, p < 0.0001). The prevalence ranged from 22% (95%CI 18.4-25.8) in first-episode to 39.5% (95%CI 32.2-47.0) in multiple-episode samples (Q = 18.27, p < 0.0001). Primary treatment resistance, defined as no response from the first episode, was 23.6% (95%CI 20.5-26.8) vs. 9.3% (95%CI 6.8-12.2) for later-onset/secondary (≥ 6 months after initial treatment response). Longer illness duration and recruitment from long-term hospitals or clozapine clinics were associated with higher prevalence estimates. In meta-regression analyses, older age and poor functioning predicted greater TRS. When including only studies with lower bias risk, the TRS prevalence was 28.4%.Conclusion:
Different study designs and recruitment strategies accounted for most of the observed heterogeneity in TRS prevalence rates. The results point to early-onset and later-onset TRS as two separate disease pathways requiring clinical attention. Registration number PROSPERO CRD42018092033.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Type d'étude:
Étude de prévalence
/
Étude pronostique
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Facteurs de risque
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Revues systématiques évaluées
langue:
Anglais
Texte intégral:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Thème du journal:
Psychiatrie
Année:
2023
Type:
Article
/
descriptif de projet
Pays d'affiliation:
Brésil
/
Canada
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États-Unis d'Amérique
Institution/Pays d'affiliation:
Centre for Addiction and Mental Health/CA
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Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP)/BR
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The Zucker Hillside Hospital/US
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Universidade Federal de São Paulo (UNIFESP)/BR
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