Understanding the course of persistent symptoms in schizophrenia: Longitudinal findings from the pattern study

Abstract

The Pattern study was conducted to provide longitudinal observational data for individual patients with persistent symptoms of schizophrenia. Pattern is an international, multicenter, non-interventional, prospective cohort study of schizophrenia outpatients who were not considered to be in recovery. In the longitudinal phase reported herein, patients were assessed over 1 year using different clinical rating scales. Patient management followed routine local clinical practice. Primary outcome was disease state, defined by the Positive and Negative Syndrome Scale (PANSS), Negative Symptom Factor Score (NSFS), Positive Symptom Factor Score (PSFS), and Personal and Social Performance (PSP) Scale. In total, 1344 protocol-compliant patients (70.9% male) were included. Patients showed a high stability in disease state between consecutive study visits. Persistent negative persistent symptoms and symptomatic remission were the most prevalent and stable disease states. Patients in relapse generally transitioned to negative persistent symptoms or to symptomatic remission. PANSS, PSP, and quality of life ratings remained relatively stable. Relapses occurred in 10% of patients; probability of relapse was associated with younger age, extra-pyramidal symptoms, and more antipsychotic medications. Despite treatment, schizophrenia symptoms tend to remain stable over time, without overall improvement. One of the greatest challenges in schizophrenia is attainment of full symptom remission.

Prednisolone versus placebo addition in the treatment of patients with recent-onset psychotic disorder: A trial design

“…However, schizophrenia remains a severe illness with high morbidity and mortality rates (3). Despite antipsychotic treatment, especially negative symptoms seem persistent over time, which negatively influences the Quality of Life (QoL) (4).…”

“…First, a significant association with the major histocompatibility complex (MHC) region, best known for its role in immunity, on chromosome 6p21. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].1 was observed in a large genome wide association study (GWAS), including over 30,000 patients with schizophrenia (9). An association between MHC and psychosis was also described by Saito and colleagues (10).…”

Avaliação das dimensões psicopatológicas da esquizofrenia resistente e não resistente ao tratamento: estudo transversal multicêntrico internacional

“…Além disso, este é o primeiro estudo a utilizar a AFC para avaliar comparativamente os seis principais modelos de AF da PANSS em pacientes com ERT, o que se mostra muito relevante uma vez que há sempre algum grau de subjetividade envolvida na interpretação de todo o processo analítico fatorial, especialmente em AFE (por exemplo, tipo de análise, método de rotação e corte de carga fatorial) e logo, a AFC apresenta superioridade em relação a AFE (28) . Além disso, existe a possível limitação de todos os estudos transversais que é o grau em que os achados representam características estáveis, pois os aglomerados de sintomas detectáveis da doença podem mudar ao longo do tempo (59) .…”

“…Para tal, utilizaremos os dados do estudo PATTERN, que foi um estudo de coorte internacional, multicêntrico, não-intervencionista, no qual 1.429 pacientes ambulatoriais estáveis portadores de esquizofrenia foram recrutados em 140 centros de oito países (Argentina, Brasil, Canadá, França, Alemanha, Itália, Espanha e Reino Unido). Os pacientes foram avaliados por várias escalas (vide abaixo na sessão de Métodos) e entre elas a PANSS (59) .…”

“…Assim o objetivo da presente dissertação é o de avaliar a estrutura fatorial da PANSS em amostras com número suficiente de sujeitos e para tal serão utilizadas toda amostra proveniente do Estudo PATTERN (59) comparando pacientes com esquizofrenia resistente a tratamento com aqueles não resistentes. (26) , Clinical Global Impression for Schizophrenia (CGI-SCH) (60) e Personal and Social Performance Scale (PSP) (61) .…”