Remission criteria for schizophrenia: evaluation in a large naturalistic cohort

Recently, remission criteria for schizophrenia have been proposed, based on low symptom severity of core symptoms (severity criterion), sustained over minimally 6 months (time criterion). Little is known, however, about the added value of the time criterion in addition to the cross-sectional severity criterion.

In order to evaluate whether remission is a valid concept for daily clinical practice, the cumulative incidence of patients meeting remission criteria was evaluated in a large naturalistic prospective study of patients with schizophrenia or schizoaffective disorder in different treatment settings in Belgium. The impact of being in remission on global and daily functioning was evaluated.

Over time, nearly 1 out of 3 patients with a diagnosis of schizophrenia or schizoaffective disorder (29%) met criteria for remission at study endpoint. Patients in remission had better insight in their disorder, a higher level of global functioning and functioned better with respect to daily living tasks, both compared to patients never meeting remission criteria and to patients only meeting the severity criterion but not the time criterion. Of the patients not meeting remission criteria at baseline, 21% attained remission at study endpoint.

The remission severity and time criteria appear to combine into a valid concept for daily clinical practice and should be a target for treatment.