Predictors of antipsychotic treatment response in patients with first episode schizophrenia, schizoaffective, and schizophreniform disorders

Perkins, Diana O.; Lieberman, J.A.; Gu, Hongbin; Tohen, Mauricio; McEvoy, Joseph P.; Green, A.; Zipursky, Robert B.; Strakowski, Stephen M.; Sharma, Tina; Kahn, René S.; Gur, Raquel E.; Tollefson, Gary D.

doi:10.1016/s0920-9964(03)80071-3

Cited by 22 publications

(26 citation statements)

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“…23,24 Social integration and participation has been reported to be a powerful predictor of a favorable clinical course. 25 Previous social functioning has consistently been found to be a good predictor of future social functioning in schizophrenia, 18 but our results also confirm that social functioning predicts good symptomatic outcomes. This can be explained by the protective role of social networks (being married, having social contacts).…”

Section: Discussionsupporting

confidence: 76%

Remission and Relapse in the Outpatient Care of Schizophrenia

Haro

Novick²,

Suarez

et al. 2006

Journal of Clinical Psychopharmacology

119

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Remission and relapse are clinical outcomes of increasing interest in schizophrenia. We analyzed remission and relapse, and the sociodemographic and clinical factors associated with these outcomes, in the usual care of schizophrenia using the 3-year, follow-up data from a large cohort of outpatients with schizophrenia taking part in the prospective, observational, European Schizophrenia Outpatient Health Outcomes study. Of the 6516 patients analyzed for remission, 4206 (64.6%) achieved remission during the 3-year, follow-up period. Logistic regression analysis revealed that being female, having a good level of social functioning at study entry, and a shorter duration of illness were factors significantly associated with achieving remission. Treatment with olanzapine was also associated with a higher frequency of remission compared with other antipsychotic agents. A Kaplan-Meier survival curve estimated that relapse occurred in approximately 25% of the patients who achieved remission, with the risk of relapse remaining constant during the follow-up period. Shorter duration of illness, having hostile behaviors, and substance abuse were factors associated with a higher risk of relapse, whereas good level of social functioning and the use of olanzapine and clozapine were associated with a lower risk of relapse. In conclusion, the 3-year results of the Schizophrenia Outpatient Health Outcomes study indicate that the likelihood of remission decreases over the longitudinal course of schizophrenia, but risk of relapse is maintained even after 3 years of achieving remission severity levels. Results suggest that treatment with olanzapine is associated with a better chance of achieving remission than other antipsychotics. Moreover, the use of olanzapine and clozapine is associated with a lower risk of relapse compared with risperidone, quetiapine, and typical antipsychotics. The results should be interpreted conservatively because of the observational, nonrandomized study design.

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Section: Discussionsupporting

confidence: 76%

Remission and Relapse in the Outpatient Care of Schizophrenia

Haro

Novick²,

Suarez

et al. 2006

Journal of Clinical Psychopharmacology

119

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“…Duration of untreated psychosis was related to overall function as measured by the WHO Disability Assessment Schedule at 2-and 15-year follow-up (11), to Heinrich-Carpenter Quality of Life at 1-year follow-up (Pearson's r=-0.29, p= 0.001) (12), and to 2-year follow-up (Pearson's r=-0.20, p<0.05) (13). In contrast, another study did not find a relationship between duration of untreated psychosis and social or vocational function at 2-year follow-up as measured by the Heinrich-Carpenter Quality of Life (14). In a study that included the "Psychiatric Status You Currently Have" interview, no relationship was found between duration of untreated psychosis and 6-month social and vocational outcomes (15).…”

Section: Duration Of Untreated Psychosis and Other Functional Outcomementioning

confidence: 90%

“…Some studies of first-episode patients have stipulated a maximum duration of untreated psychosis as an inclusion criteria (14,40,41,83). If the magnitude of the effect of duration of untreated psychosis on outcome continues to grow past the limits imposed by these study inclusion criteria, then these studies will underestimate the effect of duration of untreated psychosis on outcome.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Relationship Between Duration of Untreated Psychosis and Outcome in First-Episode Schizophrenia: A Critical Review and Meta-Analysis

Perkins¹,

Gu²,

Boteva³

et al. 2005

AJP

1,158

746

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“…More accurate information might have been obtained from multiple informants including patients and family members [12,13]. The duration of psychosis was based on single survey items, rather than a more detailed assessment such as the Interview for the Retrospective Assessment of the Onset and Early Course of Schizophrenia [14,15] or the Symptom Onset in Schizophrenia scale [16,17]. Because of the practice-based nature of this study, physicians did not use formalized scales or ratings for which reliability and validity data are available.…”

Section: Discussionmentioning

confidence: 99%

Prolonged duration of untreated psychosis in nonaffective first-episode psychotic disorders compared to other psychoses

Compton

West

Olfson

2006

International Journal of Psychiatry in Clinical Practice

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Introduction. While the consequences of the duration of untreated psychosis (DUP) represent an active area of research, less attention has been focused on the determinants of the DUP. This analysis assessed several potential determinants of the DUP from a practice-based survey. Method. Data on selected patients in their first treatment episode for psychotic symptoms were obtained from 104 practicing physicians. Patients with a long DUP (n=31), defined as >4 weeks, were compared to patients with a short DUP (≤4 weeks, n=28). Results. The long-DUP group had a higher percentage of patients with nonaffective psychotic disorders (58%) compared to the short-DUP group (29%). The median DUP among those with nonaffective psychotic disorders was 8 weeks, compared to 3 weeks among those with other psychotic disorders. The long-DUP group had a higher percentage of patients rated as uncertain about or denying a mental illness (55% compared to 25% in the short-DUP group). The presence of negative symptoms approached significance in terms of differentiating between the two groups, with 66% of the long-DUP group having negative symptoms compared to 39% of the short-DUP group. When three variables (nonaffective psychotic disorder versus other psychoses, insight, and negative symptoms) were entered into a logistic regression model, only diagnostic category remained an independently significant predictor. Conclusion. In this practice-based sample, patients with nonaffective psychotic disorders were more likely to have a longer DUP than patients who developed psychotic symptoms in the context of mood disorders, substance use disorders, or other disorders.

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Predictors of antipsychotic treatment response in patients with first episode schizophrenia, schizoaffective, and schizophreniform disorders

Cited by 22 publications

References 0 publications

Remission and Relapse in the Outpatient Care of Schizophrenia

Remission and Relapse in the Outpatient Care of Schizophrenia

Relationship Between Duration of Untreated Psychosis and Outcome in First-Episode Schizophrenia: A Critical Review and Meta-Analysis

Prolonged duration of untreated psychosis in nonaffective first-episode psychotic disorders compared to other psychoses

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