Patients with severe schizophrenia. functioning improvement after 7-year of comprehensive treatment

Abstract

Introduction

To reach not only clinical but also rehabilitation (especially to improve psychosocial functioning) goals in people with schizophrenia is a need.

Objective

To know the retention in treatment and functional outcomes of patients with severe schizophrenia enrolled in a specific and comprehensive programme for 7 years.

Method

A 7-year prospective, observational study of patients with severe schizophrenia (CGI-S of 5 or over) undergoing comprehensive programme (n = 200). Assessment included at the beginning and after 3, 6, 12, 24, 36 and 84 months: the CGI-S, the Camberwell Assessment of Needs (CAN) and the WHO-DAS. Time in treatment, reasons for discharge, laboratory tests, weight, medications, adverse effects and hospital admissions in the previous six years and during the follow-up were registered.

Results

CGI at baseline was 5.9 (0.7). After seven years, 44% of patients continued under treatment (CGI = 4.3 (0.8); P < 0.01); 36% were medical discharged (CGI = 3.4 (1.5); P < 0.001); WHO-DAS decreased in the four areas (P < 0.005) and also CAN (P < 0.01); 8% were voluntary discharges. Ten patients dead; three of them committed suicide (1.5%). Hospital admission decreased significantly (P < 0.001), and also antipsychotic combinations and antiparkinsonian medications. Fifty-five percent of all of them were treated with atypical long-acting antipsychotics, with good tolerability and few side effects (among them, only 4% were voluntary discharges).

Conclusion

Retention of patients with schizophrenia with severe symptoms and impairment in a specific and comprehensive programme was really high. Such good treatment adherence helped to get remarkable clinical and functional improvement. Long-acting medication seemed to be useful in improving treatment adherence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.