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What are residual symptoms in schizophrenia spectrum disorder? Clinical description and 1-year persistence within a naturalistic trial
ISSN
1433-8491
0940-1334
Date Issued
2015
Author(s)
Schennach, Rebecca
Riedel, Michael
Obermeier, Michael
Spellmann, Ilja
Musil, Richard
Jaeger, Markus
Schmauss, Max
Laux, Gerd
Pfeiffer, Herbert
Naber, Dieter
Schmidt, Lutz G.
Gaebel, Wolfgang
Klosterkoetter, Joachim
Heuser, Isabella
Maier, Wolfgang
Lemke, Matthias R.
Klingberg, Stefan
Gastpar, Markus
Moeller, Hans-Juergen
DOI
10.1007/s00406-014-0528-2
Abstract
The aim of this study was to evaluate residual symptoms in patients achieving remission according to the consensus criteria and to analyze their potential influence on the patient's outcome one year after discharge. In total, 399 patients suffering from a schizophrenia spectrum disorder were evaluated within a naturalistic study. Remission status was examined using the consensus criteria. Residual symptoms were defined as any symptom present at the time-point of remission following analogous analyses performed in depressed patients. Therefore, a PANSS item with a symptom severity of > 1 (= at least borderline mentally ill) was defined to be a residual symptom. Remitters with and without residual symptoms were compared regarding psychopathology, functioning and side effects. In total, 236 patients (59 %) were remitters at discharge with 94 % of them suffering from at least one residual symptom. The most common residual symptoms were blunted affect (49 %), conceptual disorganization (42 %) and social withdrawal (40 %). A significant association was found between the presence of residual symptoms and the severity of side effects (p < 0.0001) and functioning (p = 0.0003) at discharge as well as between residual symptoms and the risk of relapse and chance of remission one year after discharge. Residual symptoms were highly prevalent in remitted schizophrenia inpatients following the suggested definition. Most residual symptoms were persistent baseline symptoms suggesting an ongoing illness severity. Also, the necessity to re-evaluate the consensus criteria questioning the status of remission in these patients is also pointed out.