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Remisión sintomática y funcionamiento social/profesional en pacientes con esquizofrenia tratados ambulatoriamente: prevalencia y asociaciones en un estudio transversal

Published online by Cambridge University Press:  12 May 2020

Luis San ,
Antonio Ciudad ,
Enrique Álvarez ,
Julio Bobes  and
Inmaculada Gilaberte
Luis San
Affiliation:
Hospital San Rafael, Barcelona, España
Antonio Ciudad
Affiliation:
Laboratorios de Investigación Lilly S.A., Avda. de la Industria 30, 28108Alcobendas, Madrid, España
Enrique Álvarez
Affiliation:
Departamento de Psiquiatría, Hospital de Sant Pau, UAB, REM-TAP, Barcelona, España
Julio Bobes
Affiliation:
Área de Psiquiatría, Facultad de Medicina, Universidad de Oviedo, Oviedo, España
Inmaculada Gilaberte
Affiliation:
Laboratorios de Investigación Lilly S.A., Avda. de la Industria 30, 28108Alcobendas, Madrid, España
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Resumen

Objetivo.

El progreso de las opciones terapéuticas para la esquizofrenia ha reavivado las expectativas a largo plazo de investigadores, médicos y pacientes. Actualmente, en las definiciones de resultado terapéutico se incluyen la remisión mantenida de los síntomas y el funcionamiento adecuado en un marco conceptual, siendo la recuperación del paciente el propósito final. Nuestro objetivo fue conocer la prevalencia y los rasgos clínicos de los pacientes con esquizofrenia que consiguen estos resultados.

Métodos.

Se hizo un estudio multicéntrico y transversal en más de 100 centros de salud mental de España. Para evaluar los resultados se usaron los criterios publicados recientemente sobre la remisión sintomática basados en acuerdos operativos generales y en la escala de Evaluación Global del Funcionamiento. También se evaluaron otros aspectos clínicos, como los síntomas depresivos, la cognición social, el ajuste premórbido y las actitudes de los pacientes frente a la medicación.

Resultados.

Se analizaron los datos de 1.010 pacientes. De estos, 452 (44,8%) estaban en remisión clínica, pero sólo 103 (10,2%) tenían un funcionamiento social y/o profesional adecuado. Los factores que predicen ambos resultados son mejor ajuste premórbido (cociente de probabilidad, CP = 1,56) y mejor función cognitiva social (CP = 1,14). Otros factores, como la aceptación del tratamiento, la psicoterapia actual o pasada y la edad del paciente, no se asociaron a la funcionalidad, sino sólo a la remisión clínica. El abuso actual de sustancias y la rehabilitación anterior se asociaron a una probabilidad menor de remisión sintomática.

Conclusión.

Aunque la remisión de los síntomas en pacientes con esquizofrenia es un objetivo realista y accesible, deberían realizarse esfuerzos en el futuro para conseguir un funcionamiento prolongado adecuado en estos pacientes.

Keywords

EsquizofreniaRemisiónRecuperaciónEstudios transversales
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 15 , Issue 2 , March 2008 , pp. 65 - 74
Copyright
Copyright © European Psychiatric Association 2008

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