Universität zu Köln

Gaebel, Wolfgang, Riesbeck, Mathias, Woelwer, Wolfgang, Klimke, Ansgar ORCID: 0000-0002-1160-5270, Eickhoff, Matthias, von Wilmsdorff, Martina, Heuser, Isabella, Maier, Wolfgang, Klosterkoetter, Joachim, Falkai, Peter ORCID: 0000-0003-2873-8667, Schloesser, Ralf, Schmitt, Andrea ORCID: 0000-0002-5426-4023, Riedel, Michael, Klingberg, Stefan ORCID: 0000-0001-8081-7181, Koepcke, Wolfgang, Ohmann, Christian and Moeller, Hans-Juergen (2014). Rates and predictors of remission in first-episode schizophrenia within 1 year of antipsychotic maintenance treatment. Results of a randomized controlled trial within the German Research Network on Schizophrenia. Schizophr. Res., 152 (2-3). S. 478 - 487. AMSTERDAM: ELSEVIER. ISSN 1573-2509

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Abstract

Objective: Full and sustained symptom remission is a major treatment objective after a first-episode in schizophrenia. Findings regarding differences in remission between first-and second-generation antipsychotics are inconclusive. This study aimed to provide rates and predictors of remission in first-episode schizophrenia and to identify symptoms that prevent remission. Methods: Prevalence rates of symptomatic remission (symptom criteria only) and enduring remission (symptom and 6-month time criteria), defined according to Andreasen et al. (2005), were determined in first-episode patients participating in a RCT by the German Research Network on Schizophrenia (GRNS) that compared post-acute, 1-year maintenance treatment with risperidone or haloperidol. Respective predictors at baseline were identified by logistic and Cox regression analysis. Results: Prevalence rates were 91.5% for symptomatic remission (n = 152/166 eligible patients) and 58.6% for enduring remission (n = 65 of 111 patients who continued for at least 6 months; 39.2% of all 166 patients included), with no significant differences between risperidone and haloperidol in either type of remission. Enduring remission often was not reached because of negative symptoms: After 6 months, 40.5% of the patients had at least 1 negative symptom, whereas only 10.8% of the patients had persisting positive symptoms. Of the different predictors identified in univariate analyses, (lower) negative symptoms and participating in standardized psychological treatment remained significant in multivariate (stepwise forward) analyses for enduring remission. Conclusions: By far most of the first-episode patients reached a temporary state of full symptomatic remission within 1 year of antipsychotic treatment. However, only about 50% achieved sustained, enduring remission. Negative symptoms are still a major treatment obstacle to enduring remission in schizophrenia. (C) 2013 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gaebel, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Riesbeck, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Woelwer, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Klimke, Ansgar UNSPECIFIED orcid.org/0000-0002-1160-5270 UNSPECIFIED Eickhoff, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED von Wilmsdorff, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Heuser, Isabella UNSPECIFIED UNSPECIFIED UNSPECIFIED Maier, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Klosterkoetter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Falkai, Peter UNSPECIFIED orcid.org/0000-0003-2873-8667 UNSPECIFIED Schloesser, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitt, Andrea UNSPECIFIED orcid.org/0000-0002-5426-4023 UNSPECIFIED Riedel, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Klingberg, Stefan UNSPECIFIED orcid.org/0000-0001-8081-7181 UNSPECIFIED Koepcke, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Ohmann, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Moeller, Hans-Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-447898
DOI:	10.1016/j.schres.2013.04.012
Journal or Publication Title:	Schizophr. Res.
Volume:	152
Number:	2-3
Page Range:	S. 478 - 487
Date:	2014
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	1573-2509
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEPRESSION RATING-SCALE; 1ST EPISODE; FOLLOW-UP; SYMPTOMATIC REMISSION; EARLY INTERVENTION; PSYCHOSIS; RECOVERY; RISPERIDONE; HALOPERIDOL; RELIABILITY Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44789