Measurements of response, remission, and recovery in schizophrenia and examples for their clinical application

Different definitions of response, remission, and recovery are used in schizophrenia research, which makes comparing and applying results in clinical practice difficult. Response criteria are often based on reductions in rating scale scores (eg, ≥ 20% reduction from baseline). However, when reduction scores from rating scales, such as the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS), are linked to Clinical Global Impressions (CGI) scores, which are more easily understood, rating scale scores have better clinical application. This linking process also reveals that the widely used response cutoff of 20% does not reflect clinically meaningful improvement in patients with acute, nonrefractory schizophrenia. This article provides suggestions for selecting response criteria, displaying responder rates, and using standard definitions (eg, remission, recovery) in research studies. The ultimate goal of recovery in schizophrenia treatment includes sustained symptom resolution and a return to full functioning.