Symptomatic remission and associated factors in a catchment area based population of older patients with schizophrenia

Symptomatic remission and its associated factors have been evaluated in several studies of younger schizophrenic patients. Although the number of older individuals with schizophrenia is rapidly growing, evaluations of remission in elderly patients are scarce and limited to samples of convenience, questioning their generalizability to unselected patient populations.

We assessed the rate of symptomatic remission in a cohort of older Dutch schizophrenic patients within a psychiatric catchment area. In addition, we examined the association of symptomatic remission with measures of mental health treatment, social functioning, cognition, mood, and quality of life.

With a rate of 29.4%, symptomatic remission in this catchment area based cohort of older schizophrenic patients (mean age 68 years) was markedly lower than the rates reported for convenience samples. Remission was more frequent in schizoaffective patients, compared to patients with schizophrenia. Remitted patients were more adherent to psychiatric services and scored higher on measures of social functioning. No association with symptomatic remission could be demonstrated for cognition, mood, and quality of life.

The modest rate of symptomatic remission in this treated sample of elderly schizophrenic patients questions the notion that old age is associated with high levels of symptomatic remission. The concurrent validity of the remission concept in elderly patients merits further investigation, given the limited number of demonstrated associations.