Am J Psychiatry 162:441-449, March 2005
© 2005 American Psychiatric Association
Remission in Schizophrenia: Proposed Criteria and Rationale for Consensus
Nancy C. Andreasen, M.D., Ph.D.,
William T. Carpenter Jr., M.D.,
John M. Kane, M.D.,
Robert A. Lasser, M.D.,
Stephen R. Marder, M.D., and
Daniel R. Weinberger, M.D.
New advances in the understanding of schizophrenia etiology, course, and treatment have increased interest on the part of patients, families, advocates, and professionals in the development of consensus-defined standards for clinical status and improvement, including illness remission and recovery. As demonstrated in the area of mood disorders, such standards provide greater clarity around treatment goals, as well as an improved framework for the design and comparison of investigational trials and the subsequent evaluation of the effectiveness of interventions. Unlike the approach to mood disorders, however, the novel application of the concept of standard outcome criteria to schizophrenia must reflect the wide heterogeneity of its long-term course and outcome, as well as the variable effects of different treatments on schizophrenia symptoms. As an initial step in developing operational criteria, an expert working group reviewed available definitions and assessment instruments to provide a conceptual framework for symptomatic, functional, and cognitive domains in schizophrenia as they relate to remission of illness. The first consensus-based operational criteria for symptomatic remission in schizophrenia are based on distinct thresholds for reaching and maintaining improvement, as opposed to change criteria, allowing for alignment with traditional concepts of remission in both psychiatric and nonpsychiatric illness. This innovative approach for standardizing the definition for outcome in schizophrenia will require further examination of its validity and utility, as well as future refinement, particularly in relation to psychosocial and cognitive function and dysfunction. These criteria should facilitate research and support a positive, longer-term approach to studying outcome in patients with schizophrenia.
This article has been cited by other articles:
|
|
|
|
 
M. Moscarelli
Passive and Active Schizophrenia: Toward a New Descriptive Micropsychopathology
Schizophr Bull,
November 1, 2009;
35(6):
1183 - 1196.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. W. Fleischhacker
Second-generation antipsychotic long-acting injections: systematic review
The British Journal of Psychiatry,
November 1, 2009;
195(52):
S29 - S36.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Mihalopoulos, M. Harris, L. Henry, S. Harrigan, and P. McGorry
Is Early Intervention in Psychosis Cost-Effective Over the Long Term?
Schizophr Bull,
September 1, 2009;
35(5):
909 - 918.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. WARNER
Recovery from Disability: Manual of Psychiatric Rehabilitation
Am J Psychiatry,
August 1, 2009;
166(8):
941 - 942.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. P. Grootens, N. M. J. van Veelen, J. Peuskens, B. G. C. Sabbe, E. Thys, J. K. Buitelaar, R. J. Verkes, and R. S. Kahn
Ziprasidone Vs Olanzapine in Recent-Onset Schizophrenia and Schizoaffective Disorder: Results of an 8-Week Double-Blind Randomized Controlled Trial
Schizophr Bull,
June 19, 2009;
(2009)
sbp037v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Walter, A. Ciaramidaro, M. Adenzato, N. Vasic, R. B. Ardito, S. Erk, and B. G. Bara
Dysfunction of the social brain in schizophrenia is modulated by intention type: An fMRI study
Soc Cogn Affect Neurosci,
June 1, 2009;
4(2):
166 - 176.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Kelly, E Weiner, M. Ball, R. McMahon, W. Carpenter, and R. Buchanan
Remission in schizophrenia: the relationship to baseline symptoms and changes in symptom domains during a one-year study
J Psychopharmacol,
June 1, 2009;
23(4):
436 - 441.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. M. Cassidy, R. Norman, R. Manchanda, N. Schmitz, and A. Malla
Testing Definitions of Symptom Remission in First-Episode Psychosis for Prediction of Functional Outcome at 2 Years
Schizophr Bull,
March 25, 2009;
(2009)
sbp007v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. R. McGurk, K. T. Mueser, T. J. DeRosa, and R. Wolfe
Work, Recovery, and Comorbidity in Schizophrenia
Schizophr Bull,
March 5, 2009;
(2009)
sbn182v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Dadich and K. Muir
Tricks of the Trade in Community Mental Health Research: Working With Mental Health Services and Clients
Eval Health Prof,
March 1, 2009;
32(1):
38 - 58.
[Abstract]
[PDF]
|
|
|
|
|
|
|
L. Wunderink, S. Sytema, F. J. Nienhuis, and D. Wiersma
Clinical Recovery in First-Episode Psychosis
Schizophr Bull,
March 1, 2009;
35(2):
362 - 369.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. D. Harvey and A. S. Bellack
Toward a Terminology for Functional Recovery in Schizophrenia: Is Functional Remission a Viable Concept?
Schizophr Bull,
March 1, 2009;
35(2):
300 - 306.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Crumlish, P. Whitty, M. Clarke, S. Browne, M. Kamali, M. Gervin, O. McTigue, A. Kinsella, J. L Waddington, C. Larkin, et al.
Beyond the critical period: longitudinal study of 8-year outcome in first-episode non-affective psychosis
The British Journal of Psychiatry,
January 1, 2009;
194(1):
18 - 24.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. VALLI, O. HOWES, P. TYRER, P. McGuire, and P. M. GRASBY
Longitudinal PET Imaging in a Patient With Schizophrenia Did Not Show Marked Changes in Dopaminergic Function With Relapse of Psychosis
Am J Psychiatry,
December 1, 2008;
165(12):
1613 - 1614.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. McGrath, S. Saha, D. Chant, and J. Welham
Schizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality
Epidemiol. Rev.,
November 1, 2008;
30(1):
67 - 76.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Ascher-Svanum, A. W. Nyhuis, D. E. Faries, B. J. Kinon, R. W. Baker, and A. Shekhar
Clinical, Functional, and Economic Ramifications of Early Nonresponse to Antipsychotics in the Naturalistic Treatment of Schizophrenia
Schizophr Bull,
November 1, 2008;
34(6):
1163 - 1171.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Bodnar, A. Malla, R. Joober, and M. Lepage
Cognitive markers of short-term clinical outcome in first-episode psychosis
The British Journal of Psychiatry,
October 1, 2008;
193(4):
297 - 304.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Bibliography Schizophrenia
Focus,
April 1, 2008;
6(2):
197 - 199.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. McGrath
Dissecting the Heterogeneity of Schizophrenia Outcomes
Schizophr Bull,
March 1, 2008;
34(2):
247 - 248.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Kane and S. Leucht
Unanswered Questions in Schizophrenia Clinical Trials
Schizophr Bull,
March 1, 2008;
34(2):
302 - 309.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Davidson, T. Schmutte, T. Dinzeo, and R. Andres-Hyman
Remission and Recovery in Schizophrenia: Practitioner and Patient Perspectives
Schizophr Bull,
January 1, 2008;
34(1):
5 - 8.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Buckley, D. Bahmiller, C. A. Kenna, S. Shevitz, I. Powell, and L. Fricks
Resident Education and Perceptions of Recovery in Serious Mental Illness: Observations and Commentary
Acad Psychiatry,
December 1, 2007;
31(6):
435 - 438.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Schrank and M. Slade
Recovery in psychiatry
Psychiatr. Bull.,
September 1, 2007;
31(9):
321 - 325.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. R. S McIntyre and J. K Soczynska
Predictors of symptomatic remission in people with schizophrenia identified
Evid. Based Ment. Health,
August 1, 2007;
10(3):
73 - 73.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Mortimer
Symptom rating scales and outcome in schizophrenia
The British Journal of Psychiatry,
August 1, 2007;
191(50):
s7 - s14.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Wunderink, F. J. Nienhuis, S. Sytema, and D. Wiersma
Predictive Validity of Proposed Remission Criteria in First-Episode Schizophrenic Patients Responding to Antipsychotics
Schizophr Bull,
May 1, 2007;
33(3):
792 - 796.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. van Os, M. Drukker, J. a Campo, J. Meijer, M. Bak, and P. Delespaul
Validation of Remission Criteria for Schizophrenia
Am J Psychiatry,
November 1, 2006;
163(11):
2000 - 2002.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. A. Nasrallah and S. M. Dursun
Raising the bar for treatment expectations in schizophrenia: achieving remission as a routine goal of antipsychotic pharmacotherapy
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
3 - 5.
[PDF]
|
|
|
|
|
|
|
S. Burton
Symptom domains of schizophrenia: the role of atypical antipsychotic agents
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
6 - 19.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. S Turner and D. W Stewart
Review of the evidence for the long-term efficacy of atypical antipsychotic agents in the treatment of patients with schizophrenia and related psychoses
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
20 - 37.
[Abstract]
[PDF]
|
|
|
|
|
|
|
H. A. Nasrallah and R. Lasser
Improving patient outcomes in schizophrenia: achieving remission
J Psychopharmacol,
November 1, 2006;
20(6_suppl):
57 - 61.
[Abstract]
[PDF]
|
|
|
|
|
|
|
D. Wade, S. Harrigan, J. Edwards, P. M. Burgess, G. Whelan, and P. D. McGorry
Substance misuse in first-episode psychosis: 15-month prospective follow-up study
The British Journal of Psychiatry,
September 1, 2006;
189(3):
229 - 234.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Bellack
Scientific and Consumer Models of Recovery in Schizophrenia: Concordance, Contrasts, and Implications
Schizophr Bull,
July 1, 2006;
32(3):
432 - 442.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. REMINGTON and S. KAPUR
Remission: What's in a Name?
Am J Psychiatry,
December 1, 2005;
162(12):
2393 - 2394.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. LEUCHT, J. M. KANE, W. KISSLING, J. HAMANN, E. ETSCHEL, and R. ENGEL
Clinical implications of Brief Psychiatric Rating Scale scores
The British Journal of Psychiatry,
October 1, 2005;
187(4):
366 - 371.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Dursun
An atypical long-acting injectable antipsychotic: implications for pharmacotherapy of schizophrenia
J Psychopharmacol,
September 1, 2005;
19(5_suppl):
3 - 4.
[PDF]
|
|
|
|
|
|
|
W. Kissling, S. Heres, K. Lloyd, E. Sacchetti, P. Bouhours, R. Medori, and P. M. Llorca
Direct transition to long-acting risperidone - analysis of long-term efficacy
J Psychopharmacol,
September 1, 2005;
19(5_suppl):
15 - 21.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G. Remington and C. Shammi
Overstating the Case About Recovery?
Psychiatr Serv,
August 1, 2005;
56(8):
1022 - 1022.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. J Bromet, B. Naz, L. J Fochtmann, G. A Carlson, and M. Tanenberg-Karant
Long-Term Diagnostic Stability and Outcome in Recent First-Episode Cohort Studies of Schizophrenia
Schizophr Bull,
July 1, 2005;
31(3):
639 - 649.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Harrow, L. S Grossman, T. H Jobe, and E. S Herbener
Do Patients with Schizophrenia Ever Show Periods of Recovery? A 15-Year Multi-Follow-up Study
Schizophr Bull,
July 1, 2005;
31(3):
723 - 734.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. P. Liberman and A. Kopelowicz
Recovery From Schizophrenia: A Concept in Search of Research
Psychiatr Serv,
June 1, 2005;
56(6):
735 - 742.
[Full Text]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 2005
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
