ABSTRACT
UNLABELLED: To date, few studies have reported analytical data relating to clinical remission, functional remission and subjective experience. The present study aimed to investigate these aspects in a sample of chronic outpatients. METHODS: 112 schizophrenic or schizoaffective outpatients (Males=60; Females=52; mean age 43.5 ± 9.42 yr) were evaluated with regard to symptomatology (SCID-I; PANSS, CGI-SCH scales), functioning (PSP scale), subjective wellbeing (SWN-K scale) and Quality of Life (WHO-QoL-Bref scale). RESULTS: 50% of patients were found to be in remission. Significantly higher scores at PANNS, CGI-SCH, PSP, but not at SWN and WHO-QoL, were found among remitted patients; a relevant proportion of remitted subjects continued to manifest a moderate level of symptoms (score >3) both at PANSS (35% of cases) and CGI-SCH (29% of cases), significant functional impairment (total score <70) at PSP (68% of cases ), and a lesser degree of wellbeing (total score <80) at SWN-K (34% of cases). CONCLUSION: patients in whom clinical remission was confirmed may display persisting symptoms, relevant areas of functional impairment and a decreased sense of wellbeing.
Subject(s)
Antipsychotic Agents/therapeutic use , Personal Satisfaction , Psychotic Disorders/drug therapy , Quality of Life/psychology , Schizophrenia/drug therapy , Adult , Female , Humans , Male , Middle Aged , Outpatients , Prospective Studies , Psychiatric Status Rating Scales/statistics & numerical data , Psychotic Disorders/psychology , Psychotic Disorders/rehabilitation , Remission Induction , Schizophrenia/rehabilitation , Schizophrenic Psychology , Severity of Illness Index , Surveys and Questionnaires , Treatment OutcomeABSTRACT
BACKGROUND: Studies performed to assess the relevance of duration of untreated psychosis (DUP) as a predictor of long-term outcome (i.e. follow-ups of ten years or more) are somewhat limited. The aim of this study was to evaluate the potential association between DUP and very long-term outcome (16-33 yrs) of schizophrenia by means of a retrospective design. METHODS: Retrospective data obtained from clinical records were collected regarding DUP and outcome variables (number of hospitalizations; number of attempted suicides; course of illness; GAF scores at last observation) for a cohort of 80 outpatients (52 Males, 28 Females, mean age 51.0+/-11.58 years) affected by schizophrenia according to DSMIVTR attending a university community mental health centre. RESULTS: Mean duration of follow up was 25.2 +/- 8.68 years; mean duration of untreated psychosis was 49.00 months (range 1-312 mo), with no significant difference according to gender. Patients with a shorter DUP (=/< 1 year) displayed more frequent "favourable" courses of illness (28.9% vs 8.6%) (p = 0.025), more frequent cases with limited (=/< 3) number of hospital admissions (85.7% vs 62.1%) (p = 0.047) and a better functioning (mean GAF score = 50.32+/-16.49 vs 40.26+/-9.60, p = 0.002); regression analyses confirmed that shorter DUP independently predicted a more positive outcome in terms of number of hospital admissions, course of illness, functioning (GAF scores). CONCLUSION: A shorter DUP appears to act as a significant predictor of better outcome in schizophrenia even in the very long-term.
