Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T14:25:04.184Z Has data issue: false hasContentIssue false
  • English
  • Français

Remission as perceived by people with schizophrenia, family members and psychiatrists

Published online by Cambridge University Press:  15 April 2020

A. Karow ,
D. Naber ,
M. Lambert ,
S. Moritz  and
the EGOFORS initiative
A. Karow*
Affiliation:
Department of psychiatry and psychotherapy, psychosis early detection and intervention centre (PEDIC), centre for psychosocial medicine, university medical center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
D. Naber
Affiliation:
Department of psychiatry and psychotherapy, psychosis early detection and intervention centre (PEDIC), centre for psychosocial medicine, university medical center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
M. Lambert
Affiliation:
Department of psychiatry and psychotherapy, psychosis early detection and intervention centre (PEDIC), centre for psychosocial medicine, university medical center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
S. Moritz
Affiliation:
Department of psychiatry and psychotherapy, psychosis early detection and intervention centre (PEDIC), centre for psychosocial medicine, university medical center Hamburg-Eppendorf, Martinistrasse 52, 20246Hamburg, Germany
*
*Corresponding author. Tel.: +49 40 7410 57384; fax: +49 40 7410 55455. E-mail address: [email protected] (A. Karow).
Get access

Abstract

Introduction

Studies indicate that patient-rated outcomes and symptomatic remission as defined by the remission in schizophrenia working group rely on different assumptions. The aim of this observational study was to assess symptomatic remission by patients with schizophrenia, family members and psychiatrists and to compare their assessments with standardized criteria and clinical measures.

Methods

One hundred and thirty-one patients with schizophrenia (DSM-IV), family members and psychiatrists assessed remission within the European Group on Functional Outcomes and Remission in Schizophrenia (EGOFORS) project. Symptoms (Positive and Negative Syndrome Scale [PANSS]), functional outcome (Functional Recovery Scale in Schizophrenia [FROGS]), subjective well-being (SWN-K) and demographic characteristics were investigated.

Results

Remission assessed by psychiatrists showed the best accordance with standardized remission (80%), followed by remission assessed by family members (52%) and patients (43%). Only in 18%, patients, relatives and psychiatrists agreed in their assessments. Good subjective well-being was most important for remission estimated by patients, good subjective well-being and symptom reduction by family members, and finally better symptom scores, well-being and functioning by psychiatrists.

Discussion

Self- and expert-rated clinical outcomes differ markedly, with a preference on the patients’ side for subjective outcome. Symptomatic remission as assessed by the standardized criteria plays a secondary role for patients and relatives in daily clinical practice. A more thorough consideration of patients’ and caregivers’ perspectives should supplement the experts’ assessment.

Keywords

SchizophreniaRemissionFunctional outcomeSubjective well-being
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 6 , August 2012 , pp. 426 - 431
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N.C., Carpenter, W.T. Jr.Kane, J.M.et al.Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005; 162: 441–449.CrossRefGoogle ScholarPubMed
APA, Diagnostic and statistical manual of mental disorders. 4th ed.Washington DC: American Psychiatric Press; 1994.Google Scholar
Awad, A.G., Voruganti, L.N.The burden of schizophrenia on caregivers: a review. Pharmacoeconomics. 2008; 26: 149–162.CrossRefGoogle ScholarPubMed
Bell, M.D., Lysaker, P.H., Beam-Goulet, J.L., Milstein, R.M., Lindenmayer, J.P.Five-component model of schizophrenia: assessing the factorial invariance of the positive and negative syndrome scale. Psychiatry Res. 1994; 52: 295–303.CrossRefGoogle ScholarPubMed
Birchwood, M., Iqbal, Z., Upthegrove, R.Psychological pathways to depression in schizophrenia: studies in acute psychosis, postpsychotic depression and auditory hallucinations. Eur Arch Psychiatry Clin Neurosci. 2005; 255: 202–212.CrossRefGoogle Scholar
de Haan, L., Nimwegen, L., Amelsvoort, T., Dingemans, P., Linszen, D.Improvement of subjective well-being and enduring symptomatic remission, a 5-year follow-up of first episode schizophrenia. Pharmacopsychiatry. 2008; 41: 125–128.CrossRefGoogle ScholarPubMed
Docherty, J.P., Bossie, C.A., Lachaux, B.et al.Patient-based and clinician-based support for the remission criteria in schizophrenia. Int Clin Psychopharmacol. 2007; 22: 51–55.Google Scholar
Hofer, A., Kemmler, G., Eder, U.et al.Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. J Clin Psychiatry. 2004; 65: 932–939.CrossRefGoogle ScholarPubMed
Hofer, A., Rettenbacher, M.A., Edlinger, M.et al.Outcomes in schizophrenia outpatients treated with amisulpride or olanzapine. Pharmacopsychiatry. 2007; 40: 1–8.CrossRefGoogle ScholarPubMed
Hofer, A., Rettenbacher, M.A., Widschwendter, C.G.et al.Correlates of subjective and functional outcomes in outpatient clinic attendees with schizophrenia and schizoaffective disorder. Eur Arch Psychiatry Clin Neurosci. 2005.Google ScholarPubMed
Huppert, J.D., Weiss, K.A., Lim, R., Pratt, S., Smith, T.E.Quality of life in schizophrenia: contributions of anxiety and depression. Schizophr Res. 2001; 51: 171–180.CrossRefGoogle ScholarPubMed
Jones, P.B., Barnes, T.R., Davies, L.et al.Randomized controlled trial of the effect on quality of life of second- versus first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch Gen Psychiatry. 2006; 63: 1079–1087.CrossRefGoogle Scholar
Jungbauer, J., Stelling, K., Dietrich, S., Angermeyer, M.C.Schizophrenia: problems of separation in families. J Adv Nurs. 2004; 47: 605–613.CrossRefGoogle ScholarPubMed
Jungbauer, J., Wittmund, B., Dietrich, S., Angermeyer, M.C.The disregarded caregivers: subjective burden in spouses of schizophrenia patients. Schizophr Bull. 2004; 30: 665–675.CrossRefGoogle ScholarPubMed
Jungbauer, J., Wittmund, B., Dietrich, S., Angermeyer, M.C.Subjective burden over 12 months in parents of patients with schizophrenia. Arch Psychiatr Nurs. 2003; 17: 126–134.CrossRefGoogle ScholarPubMed
Karow, A., Czekalla, J., Dittmann, R.W.et al.Association of subjective well-being, symptoms, and side effects with compliance after 12 months of treatment in schizophrenia. J Clin Psychiatry. 2007; 68: 75–80.CrossRefGoogle Scholar
Karow, A., Moritz, S., Lambert, M., Schoder, S., Krausz, M.PANSS syndromes and quality of life in schizophrenia. Psychopathology. 2005; 38: 320–326.CrossRefGoogle Scholar
Karow, A., Pajonk, F.G., Reimer, J.et al.The dilemma of insight into illness in schizophrenia: self- and expert-rated insight and quality of life. Eur Arch Psychiatry Clin Neurosci. 2007.Google Scholar
Karow, A., Schnedler, D., Naber, D.What would the patient choose? Subjective comparison of atypical and typical neuroleptics. Pharmacopsychiatry. 2006; 39: 47–51.CrossRefGoogle ScholarPubMed
Kay, S.R., Fiszbein, A., Opler, L.A.The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13: 261–276.CrossRefGoogle Scholar
Lambert, M., Conus, P., Eide, P.et al.Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence. Eur Psychiatry. 2004; 19: 415–422.CrossRefGoogle ScholarPubMed
Lambert, M., Naber, D., Karow, A.et al.Subjective well-being under quetiapine treatment: effect of diagnosis, mood state, and anxiety. Schizophr Res. 2009; 110: 72–79.CrossRefGoogle Scholar
Lambert, M., Naber, D., Schacht, A.et al.Rates and predictors of remission and recovery during three years in 392 never-treated patients with schizophrenia. Acta Psychiatr Scand. 2008; 118: 220–229.CrossRefGoogle Scholar
Lambert, M., Schimmelmann, B.G., Naber, D.et al.Early- and delayed antipsychotic response and prediction of outcome in 528 severely impaired patients with schizophrenia treated with amisulpride. Pharmacopsychiatry. 2009; 42: 277–283.CrossRefGoogle ScholarPubMed
Lambert, M., Schimmelmann, B.G., Naber, D.et al.Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry. 2006; 67: 1690–1697.CrossRefGoogle ScholarPubMed
Llorca, P.M., Lancon, C., Lancrenon, S.et al.The “Functional Remission of General Schizophrenia” (FROGS) scale: development and validation of a new questionnaire. Schizophr Res. 2009; 113: 218–225.CrossRefGoogle ScholarPubMed
Naber, D.A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol. 10 Suppl 3 1995 133–138.Google ScholarPubMed
Naber, D., Moritz, S., Lambert, M.et al.Improvement of schizophrenic patients; subjective well-being under atypical antipsychotic drugs. Schizophr Res. 50 1–2: 2001 79–88.CrossRefGoogle ScholarPubMed
Ng, R.M., Pearson, V., Lam, M.et al.What does recovery from schizophrenia mean? Perceptions of long-term patients. Int J Soc Psychiatry. 2008; 54: 118–130.CrossRefGoogle ScholarPubMed
Potkin, S.G., Weiden, P.J., Loebel, A.D.et al.Remission in schizophrenia: 196-week, double-blind treatment with ziprasidone versus haloperidol. Int J Neuropsychopharmacol. 2009; 12: 1233–1248.CrossRefGoogle Scholar
Ritsner, M.Predicting changes in domain-specific quality of life of schizophrenia patients. J Nerv Ment Dis. 2003; 191: 287–294.CrossRefGoogle ScholarPubMed
Roick, C., Heider, D., Bebbington, P.E.et al.Burden on caregivers of people with schizophrenia: comparison between Germany and Britain. Br J Psychiatry. 2007; 190: 333–338.CrossRefGoogle ScholarPubMed
Schimmelmann, B.G., Paulus, S., Schacht, M.et al.Subjective distress related to side effects and subjective well-being in first admitted adolescents with early-onset psychosis treated with atypical antipsychotics. J Child Adolesc Psychopharmacol. 2005; 15: 249–258.CrossRefGoogle ScholarPubMed
van der Gaag, M., Cuijpers, A., Hoffman, T.et al.The five-factor model of the Positive and Negative Syndrome Scale I: confirmatory factor analysis fails to confirm 25 published five-factor solutions. Schizophr Res. 2006; 85: 273–279.CrossRefGoogle ScholarPubMed
van Os, J., Burns, T., Cavallaro, R.et al.Standardized remission criteria in schizophrenia. Acta Psychiatr Scand. 2006; 113: 91–95.Google Scholar
Submit a response

Comments

No Comments have been published for this article.