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Premorbid functioning and treatment response in recent-onset schizophrenia: prospective study with risperidone
Jonathan Rabinowitz1, Oleksandr Napryeyenko, Benjaminas Burba
1Bar Ilan University, Ramat Gan, Israel. jr827@columbia.edu
Journal of Clinical Psychopharmacology
|December 31, 2010
Summary
Good premorbid functioning in schizophrenia predicts better treatment response. This study found individuals with stable-good premorbid adjustment showed greater improvement with antipsychotic treatment, regardless of medication adherence.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Premorbid functioning is a potential predictor of antipsychotic treatment response.
- Previous studies are limited by a lack of longitudinal data and control for medication compliance.
Purpose of the Study:
- To test if good premorbid functioning predicts better antipsychotic treatment response in recent-onset schizophrenia.
- To control for medication adherence by using long-acting injectable antipsychotics.
Main Methods:
- A 6-month, open-label, multicenter, phase IV trial.
- Participants with recent-onset schizophrenia received flexible doses of risperidone long-acting injectable.
- Premorbid functioning assessed by Premorbid Adjustment Scale (PAS)-Structured Interview; efficacy by PANSS, CGI, GAF, and SF-36.
Main Results:
- Participants categorized into stable-good, stable-poor, and deteriorating premorbid functioning groups.
- All groups improved with treatment, but the stable-good group showed significantly greater improvement.
- Higher PAS global assessment scores strongly associated with baseline functioning, improvement, and achieving sustained remission.
Conclusions:
- Good premorbid functioning is associated with better treatment response in recent-onset schizophrenia.
- This association holds true when controlling for medication adherence using long-acting injectables.
- Premorbid functioning is a valuable prognostic indicator for antipsychotic treatment outcomes.
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