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Remission in the outpatient care of schizophrenia: 3-Year results from the Schizophrenia Outpatients Health Outcomes (SOHO) Study in France

Published online by Cambridge University Press:  24 June 2008

Isabelle Gasquet*
Affiliation:
National Institute of Health and Medical Research-U669, Maison de Solenn, Cochin Hospital, Paris, France Direction de la Politique Médicale, Assistance Publique-Hôpitaux de Paris, Paris, France
Josep Maria Haro
Affiliation:
Research & Development Unit, San Joan de Deu-SSM, Sant Boi, Barcelona, Spain
Stéphanie Tcherny-Lessenot
Affiliation:
Pharmacoepidemiology Unit, Lilly France, Suresnes, France
Florence Chartier
Affiliation:
Pharmacoepidemiology Unit, Lilly France, Suresnes, France
Jean-Pierre Lépine
Affiliation:
Psychiatry Department, Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
*
*Corresponding author. Address: INSERM U669, AP-HP Hôpital Cochin, Maison de Solenn, 97 Boulevard Port-Royal, 75679 Paris, France. E-mail address: [email protected] (I. Gasquet).
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Abstract

Objective

To analyse the contribution of socio-demographics, clinical profile and psychotropic treatment on remission in patients with schizophrenia.

Methods

Among 933 French outpatients recruited in the European observational Schizophrenia Outpatient Health Outcomes study (SOHO), 563 were followed-up for 3 years, had at most one missing visit, and were included in the analysis. Symptomatic remission was defined as a score of 3 (mild severity) or less on the Clinical Global Impression-Schizophrenia (CGI) overall, positive, negative and cognitive symptom scales, maintained for at least 6 months and without hospitalization. A logistic regression model was used to analyse the factors associated with time in remission.

Results

60.6% of patients achieved remission during the 3-year follow-up. Patients never treated before inclusion in the study (OR = 2.3) and those having paid employment (OR = 1.4) were more likely to achieve remission. Higher baseline clinical severity was associated with a significantly lower likelihood of achieving remission: CGI overall (OR = 0.67), CGI positive (OR = 0.85) and CGI negative (OR = 0.74). Compared with olanzapine, other atypicals (OR = 0.71) and conventional antipsychotics (OR = 0.69) were associated with a lower probability of achieving remission.

Conclusions

Remission can be achieved in a high proportion of patients. Factors such as being previously untreated, having paid employment and taking olanzapine are predictors of remission.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2008

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References

Andreasen, N.C.Carpenter, W.T.Kane, J.M.Lasser, R.A.Marder, S.R.Weinberger, D.R.Remission in schizophrenia: proposed criteria and rationale for consensus Am J Psychiatry. 162 2005 441449CrossRefGoogle ScholarPubMed
Breier, A.Schreiber, J.L.Dyer, J.Pickar, D.National Institute of Mental Health longitudinal study of chronic schizophrenia: prognosis and predictors of outcome Arch Gen Psychiatry. 48 1991 239246CrossRefGoogle ScholarPubMed
Correll, C.U.Malhotra, A.K.Kaushik, S.McMeniman, M.Kane, J.M.Early prediction of antipsychotic response in schizophrenia Am J Psychiatry. 160 2003 20632065CrossRefGoogle Scholar
Emsley, R.Oosthuizen, P.P.Kidd, M.Koen, L.Niehaus, D.J.Turner, H.J.Remission in first-episode psychosis: predictor variables and symptom improvement patterns J Clin Psychiatry. 67 2006 1707171210.4088/JCP.v67n1106CrossRefGoogle ScholarPubMed
Green, A.L.Lieberman, J.A.Hamer, R.M.Glick, I.D.Gur, R.E.Kahn, R.S.et al.Olanzapine and haloperidol in first episode psychosis: two-year data Schizophr Res. 86 2006 234243CrossRefGoogle ScholarPubMed
Haro, J.M.Edgell, E.T.Frewer, P.Alonso, J.Jones, P.B.on behalf of the SOHO Study Group The European Schizophrenia Outpatient Health Outcomes study: baseline findings across country and treatment Acta Psychiatr Scand. 107 2003 715CrossRefGoogle Scholar
Haro, J.M.Edgell, E.T.Jones, P.B.Alonso, J.Gavart, S.Gregor, K.J.et al.The European Schizophrenia Outpatient Health Outcomes (SOHO) study: rationale, methods and recruitment Acta Psychiatr Scand. 107 2003 222232CrossRefGoogle ScholarPubMed
Haro, J.M.Kamath, S.A.Ochoa, S.Novick, D.Rele, K.Fargas, A.et al.The Clinical Global Impression Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia Acta Psychiatr Scand. 107 2003 162310.1034/j.1600-0447.107.s416.5.xCrossRefGoogle Scholar
Haro, J.M.Novick, D.Belger, M.Jones, P.B.the SOHO advisory board Antipsychotic type and correlates of antipsychotic treatment discontinuation in the outpatient treatment of schizophrenia Eur Psychiatry. 21 2006 4147CrossRefGoogle ScholarPubMed
Haro, J.M.Novick, D.Suarez, D.Alonso, J.Lepine, J.P.Ratcliffe, M.et al.Remission and relapse in the outpatient care of schizophrenia: three-year results from the Schizophrenia Outpatient Health Outcomes study J Clin Psychopharmacol. 26 2006 571578CrossRefGoogle ScholarPubMed
Haro, J.M.Ochoa, S.Gervin, M.Mavreas, V.Jones, P.Assessment of remission in schizophrenia with the CGI and CGI-SCH scales Acta Psychiatr Scand. 115 2007 163164CrossRefGoogle ScholarPubMed
Haro, J.M.Suarez, D.Novick, D.Brown, J.Usall, J.Naber, D.Three-year antipsychotic effectiveness in the outpatient care of schizophrenia: observational versus randomized studies results Eur Neuropsychopharmacol. 17 2007 235244CrossRefGoogle ScholarPubMed
Jablensky, A.Epidemiology of schizophrenia: the global burden of disease and disability Eur Arch Psychiatry Clin Neurosci. 250 2000 274285CrossRefGoogle ScholarPubMed
Lambert, M.Schimmelmann, B.G.Naber, D.Schacht, A.Karow, A.Wagner, T.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. 67 2006 16901697CrossRefGoogle ScholarPubMed
Leucht, S.Heres, S.Epidemiology, clinical consequences, and psychosocial treatment of nonadherence in schizophrenia J Clin Psychiatry. 67 Suppl. 5 2006 38Google Scholar
Leucht, S.Kane, J.M.Measurement-based psychiatry: definitions of response, remission, stability, and relapse in schizophrenia J Clin Psychiatry. 67 2006 18131814CrossRefGoogle Scholar
Leucht, S.Lasser, R.The concepts of remission and recovery in schizophrenia Pharmacopsychiatry. 39 2006 161170CrossRefGoogle Scholar
Liberman, R.P.Kopelowicz, A.Recovery from schizophrenia: a concept in search of research Psychiatr Serv. 56 2005 735742CrossRefGoogle ScholarPubMed
Lieberman, J.A.Stroup, T.S.McEvoy, J.P.Swartz, M.S.Rosenheck, R.A.Perkins, D.O.et al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia N Engl J Med. 353 2005 12091223CrossRefGoogle ScholarPubMed
Perkins, D.O.Gu, H.Boteva, K.Lieberman, J.A.Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis Am J Psychiatry. 162 2005 17851804CrossRefGoogle ScholarPubMed
Robinson, D.G.Woerner, M.G.McMeniman, M.Mendelowitz, A.Bilder, R.M.Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder Am J Psychiatry. 161 2004 473479CrossRefGoogle ScholarPubMed
Rosen, K.Garety, P.Predicting recovery from schizophrenia: a retrospective comparison of characteristics at onset of people with single and multiple episodes Schizophr Bull. 31 2005 735750CrossRefGoogle ScholarPubMed
Sethuraman, G.Taylor, C.G.Enerson, M.Dunayevich, E.A retrospective comparison of cumulative time spent in remission during treatment with olanzapine or risperidone among patients with schizophrenia Schizophr Res. 79 2005 337340CrossRefGoogle ScholarPubMed
Tandon, R.Targum, S.D.Nasrallah, H.A.Ross, R.Treatment Effectiveness in Schizophrenia Consortium. Strategies for maximizing clinical effectiveness in the treatment of schizophrenia J Psychiatr Pract. 12 2006 348363CrossRefGoogle ScholarPubMed
Uçok, A.Polat, A.Genç, A.Cakir, S.Turan, N.Duration of untreated psychosis may predict acute treatment response in first-episode schizophrenia J Psychiatr Res. 38 2004 163168CrossRefGoogle ScholarPubMed
Van Os, J.Burns, T.Cavallaro, R.Leucht, S.Peuskens, J.Helldin, L.et al.Standardized remission criteria in schizophrenia Acta Psychiatr Scand. 113 2006 9195Google Scholar
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