European Long-term Followup Studies of Schizophrenia

Angst, Jules

doi:10.1093/schbul/14.4.501

Cited by 97 publications

(72 citation statements)

References 58 publications

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“…This is also compatible with the Scandinavian tradition. In contrast to K. Schneider [2], the Scandinavian concept of schizophrenia, often referred to as 'nuclear schizophrenia' or 'process schizophrenia' [31], is narrower because it usually considers schizophrenia as a chronic disorder, separate from reactive psychoses [4,32].…”

Section: Impact Of Negative Symptomsmentioning

confidence: 99%

On the Descriptive Validity of ICD-10 Schizophrenia: Empirical Analyses in the Spectrum of Non-Affective Functional Psychoses

et al. 2003

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In order to examine the descriptive validity of ICD-10 schizophrenia, 1,476 consecutively admitted in-patients were included in the present study. ICD-10 schizophrenia (n = 951) was compared with other non-affective psychotic disorders [persistent delusional disorders (n = 51), acute and transient psychotic disorders (n = 116) and schizoaffective disorders (n = 354)] with respect to sociodemographic, symptomatological and other clinical parameters. Analyses revealed that it is possible to distinguish schizophrenia from other non-affective psychotic disorders according to ICD-10 criteria: schizophrenic patients were characterised by more pronounced negative symptoms and a lower global functioning. They were younger than patients with persistent delusional disorders and schizoaffective disorders but older than patients with acute and transient psychotic disorders. The results are in line with a high descriptive validity of ICD-10 schizophrenia and highlight the importance of negative symptoms for this diagnosis.

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Section: Impact Of Negative Symptomsmentioning

confidence: 99%

On the Descriptive Validity of ICD-10 Schizophrenia: Empirical Analyses in the Spectrum of Non-Affective Functional Psychoses

et al. 2003

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“…[11][12][13][14] While the definitions of remission and recovery have been the subject of a systematic review, 3 to the best of our knowledge, only 3 studies have examined the empirical data on "good outcomes" in schizophrenia using systematic reviews and/or meta-analytic techniques. [15][16][17] According to a meta-analysis by Hegarty et al, 15 based of 320 studies published between 1895 and 1992, approximately 40% of schizophrenia patients were considered as having a good outcome.…”

mentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Recovery in Schizophrenia

Jääskeläinen

Juola

Hirvonen

et al. 2012

Schizophrenia Bulletin

733

496

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Objective: Our primary aims were (a) to identify the proportion of individuals with schizophrenia and related psychoses who met recovery criteria based on both clinical and social domains and (b) to examine if recovery was associated with factors such as gender, economic index of sites, and selected design features of the study. We also examined if the proportions who met our definition of recovery had changed over time. Method: A comprehensive search strategy was used to identify potential studies, and data were extracted for those that met inclusion criteria. The proportion who met our recovery criteria (improvements in both clinical and social domains and evidence that improvements in at least 1 of these 2 domains had persisted for at least 2 years) was extracted from each study. Meta-regression techniques were used to explore the association between the recovery proportions and the selected variables. Results: We identified 50 studies with data suitable for inclusion. The median proportion (25%-75% quantiles) who met our recovery criteria was 13.5% (8.1%-20.0%). Studies from sites in countries with poorer economic status had higher recovery proportions. However, there were no statistically significant differences when the estimates were stratified according to sex, midpoint of intake period, strictness of the diagnostic criteria, duration of follow-up, or other design features. Conclusions: Based on the best available data, approximately, 1 in 7 individuals with schizophrenia met our criteria for recovery. Despite major changes in treatment options in recent decades, the proportion of recovered cases has not increased.Key words: schizophrenia/psychosis/recovery/outcome studies/prognosis/epidemiology It is widely accepted that a proportion of individuals who develop schizophrenia have a favorable prognosis. Symptoms can abate over time, and a proportion of those with schizophrenia attain good outcomes on a range of clinical and functional outcomes (eg, education, employment, and relationships). The precise proportion of cases that have favorable outcomes is less clearly understood. To a large degree, this relates to uncertainty about how to measure multifaceted outcomes such as "recovery." Considering how much research attention has been allocated to exploring the onset of psychosis (eg, prodrome and early psychosis), it is appropriate that a comparable degree of research scrutiny also be accorded to the recovery of psychosis.

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“…The values represent the mean (±standard deviation); GWB: assessment of general status; PANSS-P: positive symptoms; PANSS-N: negative symptoms; PANSS-G: general psychopathology; SI: severity of illness; GI: global improvement; eI: efficacy index; SCH(±): dominant positive/negative symptoms. 3.41 (df=19, p<0.01), and 3.14 (df=19, p<0.01), respectively. More adverse effects were reported in the chlorpromazine group (3.2 drug adverse reactions per patients), than in subjects who received haloperidol (2.7) and clozapine (0.9) ( Table 5).…”

Section: Resultsmentioning

confidence: 93%

“…With the works of Crow and associates in the early 1980s and the concepts of dividing schizophrenia into type I and type II 2 the new dilemmas emerged. The main problem was the question of chronic schizophrenia, particularly negative symptoms 3 . This gap between drug efficacy and the clinical need opened the possibility for further basic and clinical researches to define more valid and predictive criteria for antipsychotic use within both typical and atypical classes 4 .…”

mentioning

confidence: 99%

Effectiveness of clozapine, haloperidol and chlorpromazine in schizophrenia during a five-year period

Ravanic

Dejanovic

Janjić

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: The aim of our study was to evaluate the effects of low doses of clozapine in flexible regime in comparison with haloperidol and chlorpromazine in long term. Method: The naturalistic study was prospective, active-controlled with 325 adult outpatients of both genders (140 females), with mean year age of 34.8 (range 21-57), suffering from chronic schizophrenia. The first onset of illness was at the mean of 27.9 years (range 17-38), and subjects had the mean year age of 4.1±0.5 previous relapses. The patients were allocated to receive haloperidol (105 subjects, dose range 2-15 mg), chlorpromazine (n=105, 100-400 mg) or clozapine (n=115, 75-600 mg). The scores of psychometric instruments (GWB, PANSS, CGI) were regularly assessed during 5 year period. Results: The sixty-six responders were included in per-protocol analysis: 12, 10 and 16 with positive and 7, 6 and 15 with negative schizophrenic syndrome in haloperidol, chlorpromazine and clozapine group, respectively. The statistically significant differences in all psychometric scores was found, for both schizophrenic syndromes, favoring clozapine. The distribution of eighteen different types of adverse events, which we noted, were significantly different among treatment groups (χ 2 =315.7, df=34, p<0.001). Clozapine was safer and had fewer adverse effects (average of 0.9 adverse events per patient) than haloperidol (2.7) and chlorpromazine (3.2). Conclusions: Clozapine, in low doses of flexible regime, in long term (five years) showed better effectiveness in chronic schizophrenics with positive and negative symptoms than typical antipsychotics.Key WordS: schizophrenia, antipsychotics drugs, long-term outcomes, clinical practice. Eficácia da clozapina, haloperidol e clorpromazina na esquizofrenia em um período de cinco anosResumo -Objetivo: o propósito deste estudo foi avaliar os efeitos de baixas doses de clozapina em regime flexível comparando com o uso de haloperidol e clorpromazina por período de 5 anos. Método: Um estudo prospectivo naturalístico, ativo-controlado foi realizado com 325 pacientes com idade média de 34,8 (variância 21-57). Todos com diagnóstico de esquizofrenia. No primeiro surto da doença os pacientes apresentavam idade média de 27,9 anos (variância 17-38) e os surtos subsequentes apareceram em média 4,1±0,5 anos após. os pacientes foram orientados a receberem haloperidol (105 pacientes com dose entre 2 e 15 mg), clorpromazina (105 pacientes com dose entre 100 e 400 mg) e clozapina (115 pacientes com dose entre 75 e 600 mg). os instrumentos psicométricos utilizados (GWB, PANSS e CGI) foram regularmente empregados durante os 5 anos do estudo. Resultados: os 66 pacientes respondedores ao tratamento foram incluídos no protocolo de análise: 12, 10 e 16 apresentavam síndrome esquizofrênica positiva e 7, 6 e 15 síndrome negativa esquizofrênica com haloperidol, clorpromazina e clozapina, respectivamente. diferenças estatísticas significantes foram observadas em todas as avaliações psicométricas em ambas síndromes esquizofrênicas f...

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European Long-term Followup Studies of Schizophrenia

Cited by 97 publications

References 58 publications

On the Descriptive Validity of ICD-10 Schizophrenia: Empirical Analyses in the Spectrum of Non-Affective Functional Psychoses

On the Descriptive Validity of ICD-10 Schizophrenia: Empirical Analyses in the Spectrum of Non-Affective Functional Psychoses

A Systematic Review and Meta-Analysis of Recovery in Schizophrenia

Effectiveness of clozapine, haloperidol and chlorpromazine in schizophrenia during a five-year period

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