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Pharmacopsychiatry 2009; 42(6): 277-283
DOI: 10.1055/s-0029-1234105
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Early- and Delayed Antipsychotic Response and Prediction of Outcome in 528 Severely Impaired Patients with Schizophrenia Treated with Amisulpride

M. Lambert1 , 5 , B. G. Schimmelmann2 , 5 , D. Naber1 , F.-X. Eich3 , H. Schulz4 , C. G. Huber1 , A. Karow1
  • 1Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf
  • 2Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Germany
  • 3Sanofi-aventis Deutschland GmbH, Germany
  • 4Centre for Psychosocial Medicine, Department of Psychological Medicine of the University Hospital Hamburg-Eppendorf
  • 5Denotes equal contribution
Further Information

Publication History

received 29.08.2008 revised 06.05.2009

accepted 11.05.2009

Publication Date:
18 November 2009 (online)

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Abstract

Introduction: ‘Early-onset’ studies have shown that symptomatic response often occurs early and that early symptomatic response is predictive for later outcome. Limiting factors of these studies include the restriction on symptomatic outcome, the inclusion of mostly moderately ill patients, and the use of various antipsychotics.

Methods: Response and remission rates were assessed in 528 severely ill patients with schizophrenia at baseline, week 2, 4 and 12 using PANSS, SWN-K, CGI-S, and SOFAS. The clinical measures were combined to one outcome criterion (CombOut). Predicitive validity was analyzed for CombOut using linear regression models.

Results: Rate and time to response differed markedly between outcome measures. 32% reached positive symptom response at week 2, 58% at week 4 and 85% at week 12. Non-response at week 4, but not at week 2 was predictive for later non-response. The combined outcome criterion was best predicted by early response in subjective wellbeing (T=−7.88, p<0.001) and social functioning (T=−7.43, p<0.001).

Discussion: Rate and time to response might depend on sample characteristics and outcome measure. In severely ill patients early antipsychotic response is possibly delayed from the first 2 to the first 4 weeks. Early response in subjective wellbeing and social functioning are strong predictors for overall outcome, which make them a useful supplementation to the assessment of symptomatic response.

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Correspondence

M. LambertMD 

Psychosis Early Detection and Intervention Centre (PEDIC)

Department of Psychiatry and Psychotherapy

Centre for Psychosocial Medicine

University Medical Center

Hamburg-Eppendorf

Martinistraße 52

20246 Hamburg

Germany

Phone: 0049/40/7410 576 70

Fax: 0049/40/7410 554 55

Email: lambert@uke.uni-hamburg.de

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