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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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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