Abstract
Introduction: ‘Early-onset’ studies have shown that symptomatic response often occurs early and
that early symptomatic response is predictive for later outcome. Limiting factors
of these studies include the restriction on symptomatic outcome, the inclusion of
mostly moderately ill patients, and the use of various antipsychotics.
Methods: Response and remission rates were assessed in 528 severely ill patients with schizophrenia
at baseline, week 2, 4 and 12 using PANSS, SWN-K, CGI-S, and SOFAS. The clinical measures
were combined to one outcome criterion (CombOut). Predicitive validity was analyzed
for CombOut using linear regression models.
Results: Rate and time to response differed markedly between outcome measures. 32% reached
positive symptom response at week 2, 58% at week 4 and 85% at week 12. Non-response
at week 4, but not at week 2 was predictive for later non-response. The combined outcome
criterion was best predicted by early response in subjective wellbeing (T=−7.88, p<0.001)
and social functioning (T=−7.43, p<0.001).
Discussion: Rate and time to response might depend on sample characteristics and outcome measure.
In severely ill patients early antipsychotic response is possibly delayed from the
first 2 to the first 4 weeks. Early response in subjective wellbeing and social functioning
are strong predictors for overall outcome, which make them a useful supplementation
to the assessment of symptomatic response.
References
Diagnostic criteria for research . In. Geneva: WHO 1993 ECDEU Assessment Manual for Psychopharmacology, rev. Rockville . US Department of Health, Education and Welfare, Public Health Service, Alcohol,
Drug Abuse and Mental Health Administration, NIMH Psychopharmacology Research Branch.
Division of Extramural Research Programms 1976: pp. 218-222 Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington . DC: American Psychiatric Press 1994 Psychiatric services . Washington, DC 2005 56: 735-742
Correspondence
lambert@uke.uni-hamburg.de
