Relationship Between Symptomatic Improvement and Overall Illness Severity in Patients With Schizophrenia

Abstract

In conclusion, change in overall illness severity, as determined by clinicians, is not necessarily interchangeable with patients' view of improvement of their own clinical status. Moreover, changes in the 2 evaluations of illness severity are associated with changes in different symptom domains.

Factors associated with poor satisfaction with treatment and trial discontinuation in chronic schizophrenia

“…In their study, a change in positive psychotic symptoms was the strongest predictor of clinician-rated illness severity scores, whereas improvement in depressive symptoms was the strongest predictor of improvement in illness severity, as rated by the patient. 41,42 These findings, together with our results, are in accord with the interview findings of Kuhnigk et al 18 demonstrating that clinicians are primarily focused on psychotic symptom control while patients diagnosed with schizophrenia rank fewer depressive thoughts and emotional distress of highest importance as treatment goals.…”

“…These results are in line with earlier findings demonstrating that investigators and patients weigh the merits of antipsychotic treatment in partially different ways. For example, Fervaha and coworkers 41,42 found that change in overall illness severity, as determined by clinicians, was not interchangeable with patients' views of improvement of their illness status. In their study, a change in positive psychotic symptoms was the strongest predictor of clinician-rated illness severity scores, whereas improvement in depressive symptoms was the strongest predictor of improvement in illness severity, as rated by the patient.…”