Remission in schizophrenia - What are we measuring? Comparing the consensus remission criteria to a CGI-based definition of remission and to remission in major depression

被引：7

作者：

Schennach, Rebecca ^{[1
,20
]}

Obermeier, Michael ^{[1
]}

Spellmann, Ilja ^{[1
,21
]}

Seemueller, Florian ^{[1
]}

Musil, Richard ^{[1
]}

Jaeger, Markus ^{[1
,22
]}

Schmauss, Max ^{[2
]}

Laux, Gerd ^{[3
]}

Pfeiffer, Herbert ^{[4
]}

Naber, Dieter ^{[5
]}

Schmidt, Lutz G. ^{[6
]}

Gaebel, Wolfgang ^{[7
]}

Klosterkoetter, Joachim ^{[8
]}

Heuser, Isabella ^{[9
]}

Bauer, Michael ^{[10
]}

Adli, Mazda ^{[11
]}

Zeiler, Joachim ^{[12
]}

Bender, Wolfram ^{[4
]}

Kronmueller, Klaus-Thomas ^{[13
]}

Ising, Marcus ^{[14
]}

Brieger, Peter ^{[4
]}

Maier, Wolfgang ^{[15
]}

Lemke, Matthias R. ^{[16
]}

Ruether, Eckart ^{[17
]}

Klingberg, Stefan ^{[18
]}

Gastpar, Markus ^{[19
]}

Moeller, Hans-Juergen ^{[1
]}

Riedel, Michael ^{[1
,23
]}

机构：

[1] Ludwig Maximilians Univ Munchen, Dept Psychiat & Psychotherapy, Munich, Germany

[2] Dist Hosp Augsburg, Psychiat Clin, Augsburg, Germany

[3] Inn Salzach Hosp Wasserburg Inn, Psychiat Clin, Wasserburg, Germany

[4] Kbo Isar Amper Klinikum Haar, Dept Psychiat & Psychotherapy Munich East, Haar, Germany

[5] Univ Hamburg, Dept Psychiat & Psychotherapy, Hamburg, Germany

[6] Johannes Gutenberg Univ Mainz, Dept Psychiat & Psychotherapy, Mainz, Germany

[7] Heinrich Heine Univ Dusseldorf, Fac Med, Dept Psychiat & Psychotherapy, Dusseldorf, Germany

[8] Univ Cologne, Dept Psychiat & Psychotherapy, Cologne, Germany

[9] Charite, Dept Psychiat & Psychotherapy, Campus Benjamin Franklin, Berlin, Germany

[10] Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Psychiat & Psychotherapy, Dresden, Germany

[11] Fliedner Klin Berlin, Berlin, Germany

[12] Auguste Viktoria Krankenhaus Berlin, Dept Psychiat & Psychotherapy, Berlin, Germany

[13] LWL Klinikum Gutersloh, Gutersloh, Germany

[14] Max Planck Inst Psychiat, Munich, Germany

[15] Univ Bonn, Dept Psychiat & Psychotherapy, Bonn, Germany

[16] Alsterdorf Hosp, Dept Psychiat, Hamburg, Germany

[17] Univ Gottingen, Dept Psychiat & Psychotherapy, Gottingen, Germany

[18] Univ Tubingen, Dept Psychiat & Psychotherapy, Tubingen, Germany

[19] Univ Essen Gesamthsch, Dept Psychiat & Psychotherapy, Essen, Germany

[20] Schon Clin Roseneck, Roseneck 6, D-83209 Prien Am Chiemsee, Germany

[21] Klinikum Stuttgart, Dept Special Psychiat Social Psychiat & Psychothe, Stuttgart, Germany

[22] Bezirkskrankenhaus Kempten, Dept Psychiat Psychosomat & Psychotherapy, Kempten, Germany

[23] Psychiat Clin Rodewisch, Rodewisch, Germany

来源：

SCHIZOPHRENIA RESEARCH | 2019年 / 209卷

关键词：

Schizophrenia; Remission; Consensus criteria; Asymptomatic status; BIOLOGICAL-PSYCHIATRY WFSBP; SYMPTOMATIC REMISSION; WORLD-FEDERATION; RECOVERY; VALIDITY; SCALE; ARIPIPRAZOLE; OUTPATIENTS; RISPERIDONE; PREDICTORS;

D O I：

10.1016/j.schres.2019.04.022

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background: Despite being recommended for use in clinical trials, the consensus remission criteria were found to leave patients with persisting symptoms, relevant areas of functional impairment and a decreased sense of wellbeing. Therefore, to evaluate the appropriateness of the schizophrenia consensus criteria, a definition of remission based on the Clinical Global Impression Scale (CGI) was developed and remitter subgroups were compared. Methods: 239 patients with a schizophrenia spectrum disorder were evaluated regarding their remission status after inpatient treatment. Remission in schizophrenia was defined according to the symptom-severity component of the consensus criteria by Andreasen et al. and a CGI based definition was calculated using sensitivity and specificity using receiver operating curves (asymptomatic remitter). Both remitter groups (schizophrenia consensus versus asymptomatic remitters) were compared regarding different clinical variables at discharge as well as the likelihood to relapse within a 1-year follow-up period. Both schizophrenia remitter subgroups were compared to remitters in major depression as a reference value. Results: Following the consensus criteria, 63% of the schizophrenia patients were in remission compared to only 18% following the asymptomatic criterion. The schizophrenia consensus remitters were less likely to be concurrent treatment responders (p < 0.0001), had a significantly greater illness severity (p < 0.0001) and less functioning (p = 0.0358) as well as a significantly greater risk to relapse (p = 0.0174) compared to the schizophrenia asymptomatic remitters as well as the depressed remitters. Conclusion: It should be critically re-evaluated if the currently proposed consensus criteria are adequate to measure what is traditionally understood to be remission. (C) 2019 Elsevier B.V. All rights reserved.

引用

页码：185 / 192

页数：8

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