Measurement of therapeutic response in schizophrenia. A critical survey

A recurrent criticism of measurement in schizophrenia research is that symptom suppression is overemphasized as the sole criterion measure of treatment effectiveness, to the neglect of other endpoints, such as the quality of life and subjective experience of the patient. This paper addresses the current status of response measures used in schizophrenia therapeutics. A computer literature search of all clinical trials (drug, psychosocial, or rehabilitative) in schizophrenia for the years 1986 through 1989 yielded 175 papers, 79 of which were trials of therapy. Almost all the trials focused on productive symptoms, with 19% considering negative symptoms scales as well. Approximately one-quarter of the studies incorporated some measure of patient functioning, but only 13% considered the patient's self-report or ratings of significant others. The findings suggest that the measurement of treatment response in schizophrenia research continues to be unidimensional and symptom-based. It is proposed that treatment effectiveness may be obscured when measures of patient functioning, subjective experience and assessments of significant others are not included with those of symptomatology.