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An early improvement threshold to predict response and remission in first-episode schizophrenia
Rebecca Schennach-Wolff1, Florian Hannes Seemüller, Andreas Mayr
1Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstrasse 7, Muenchen 80336, Germany. rebecca.schennach-wolff@med.uni-muenchen.de
Background:
Early improvement with treatment is thought to be important in patients with first-episode schizophrenia, yet a valid definition is still outstanding.
Aims:
To develop a valid definition of early improvement and test its predictive validity regarding response and remission.
Method:
We examined 188 in-patients with first-episode schizophrenia. Early improvement was defined as improvement in Positive and Negative Syndrome Scale (PANSS) total score at week 2, response as a 40% PANSS total score improvement at end-point, and remission according to consensus criteria.
Results:
Reasonable predictive validity of early improvement was found for a 46% PANSS total score improvement at week 2 and a 50% improvement for remission (area under the curve: response 0.707, remission 0.692). Estimated confidence intervals ranged from 26 to 62% PANSS reduction for response and remission.
Conclusions:
Patients with a first episode of schizophrenia should improve by at least 30% in PANSS total score at week 2 to achieve response and remission.
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