Psychometric and clinical evaluation of schizophrenia remission criteria in outpatients with psychotic disorders

Abstract

Background Psychotic disorders such as schizophrenia have debilitating effects on health and functioning. Given symptomatic remission’s recent emergence as a viable treatment goal, the Remission in Schizophrenia Working Group’s criteria (RSWG-cr), based on eight items from the Positive and Negative Syndrome Scale (PANSS-8), are frequently used in clinical and research settings. Against that background, we sought to evaluate the PANSS-8’s psychometric properties and examine the RSWG-cr’s clinical validity among outpatients in Sweden. Methods Cross-sectional register data were collected from outpatient psychosis clinics in Gothenburg, Sweden. Following confirmatory and exploratory factor analyses of PANSS-8 data (n = 1,744) to assess the PANSS-8’s psychometric properties, internal reliability was evaluated using Cronbach’s alpha. Next, 649 of the patients were classified according to the RSWG-cr and their clinical and demographic characteristics compared. Binary logistic regression was used to estimate odds ratios (OR) and assess each variable’s impact on remission status. Results The PANSS-8 showed good reliability (α = .85), and the 3D model of psychoticism, disorganization, and negative symptoms presented the best model fit. According to the RSWG-cr, 55% of the 649 patients were in remission; they were also more likely to live independently, be employed, not smoke, not take antipsychotics, and have recently received a health interview and physical examination. Patients living independently (OR = 1.98), who were employed (OR = 1.89), who were obese (OR = 1.61), and who had recently received a physical examination (OR = 1.56) also had an increased likelihood of remission. Conclusions The PANSS-8 is internally reliable, and, according to the RSWG-cr, remission is associated with variables of interest for patients’ recovery, including living independently and being employed. Although our findings from a large, heterogeneous sample of outpatients reflect everyday clinical practice and reinforce past observations, the directions of those relationships need to be assessed in longitudinal studies.

“You Have No Idea How Much ‘Just Get the Shot’ Is Triggering Me”: Experiences of COVID-19 Vaccination in Individuals with Psychosis and Schizophrenia

“…In particular, our data do not allow us to distinguish between those who are responsive or resistant to treatment. These populations may differ in important ways, for example with respect to symptomology, lifestyle, and previous interactions with medical professionals (Nuciflora et al 2019;Panov and Panova 2023;Sakinyte and Holmberg 2023). Future research should explore the lived experience of COVID-19-related issues such as vaccination in each clinical group.…”

Oral Health Status and Factors Related to Oral Health in Patients with Schizophrenia: A Matched Case-Control Observational Study

“…Patients diagnosed with SCZ were selected through a random stratified sampling method—based on age and gender—from a larger pool of patients at the Schizophrenia Ward or the Rehabilitation Center at the Department of Psychiatry [ 30 ]. To establish a consistent baseline and to mitigate variations associated with the acute phase of the disease, only SCZ patients in the remission state were eligible to participate [ 31 ]. ( ii ) Controls, i.e., generally healthy individuals willing to participate, without a psychiatric disorder (and not taking any psychiatric medications) or other severe systemic illnesses, seeking dental treatment at the Faculty of Dentistry, University of Szeged, Hungary.…”