Fewer than one in ten people with schizophrenia show sustained improvement over 3 years

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This large prospective observational study followed 1,635 chronically ill patients with schizophrenia for a 3 year period. The aim was to identify the best baseline predictors of recovery.

Sixty-two factors were assessed as possible prognostic variables, including patient-reported variables, clinician-rated variables and medical record based resource utilisation.

Here’s what they found:

The likelihood of a sustained favourable long-term outcome was associated with:

  • Being employed (OR 1.98, 95% CI 1.34 to 2.91)
  • The ability to shop independently (OR 1.76, 95% CI 1.19 to 2.59)
  • The ability to undertake independent leisure activities (OR 1.75, 95% CI 1.10 to 2.79)
  • Experiencing clearer thoughts from medications (OR 1.21, 95% CI 1.04 to 1.40)
  • Better quality of life (OR 1.64, 95% CI 1.32 to 2.03)
  • Better global functioning (OR 1.04, 95% CI 1.02 to 1.06)
  • More daily activities (OR 1.27, 95% CI 1.06 to 1.52)

The likelihood of experiencing a sustained favourable long-term outcome was lower in:

  • Those who had received individual therapy (OR 0.47, 95% CI 0.25 to 0.88)
  • Or who had been a victim of crime (OR 0.38, 95% CI 0.17 to 0.85)

The authors concluded:

Only a small percentage of patients achieved sustained favourable long-term outcome in this study, suggesting there continues to be a great need for improvement in the treatment of schizophrenia. Findings suggest that clinicians could make early projections of health states and identify those patients more likely to achieve favourable long-term outcomes enabling early therapeutic interventions to enhance benefits for patients.

Cuyún Carter GB, Milton DR, Ascher-Svanum H, Faries DE. Sustained favorable long-term outcome in the treatment of schizophrenia: a 3-year prospective observational study. BMC Psychiatry. 2011 Aug 26;11:143.

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