Most schizophrenia patients improve with treatment

MedWire News: Most patients with schizophrenia do not experience a deteriorating course of illness and improve with treatment, study results indicate.

Previous studies have indicated that many patients with schizophrenia experience worsening symptoms.

"However, most of these studies relied on non-first-episode [patients] and were biased towards patients who experienced multiple hospital admissions and included patients at varying stages of illness," explain Dr E O'Callaghan, from University College Dublin in Ireland, and colleagues.
They add that the results of some recent studies have indicated that "the outcome of schizophrenia appears to be more favourable than once thought".

To investigate further, the team studied 97 patients with a first episode of schizophrenia symptoms and monitored them over a period of 4 years.

All the participants underwent a variety of tests during the monitoring period to assess their levels of positive symptoms, such as delusions and hallucinations, and negative symptoms, such as social withdrawal and communication problems. Each participant's period of untreated psychosis before diagnosis was also noted.

The researchers found that, on average, there was around a 50% reduction in the severity and frequency of positive symptoms among the patients over the course of the study period, and a significant reduction in their levels of negative symptoms.

Analysis also revealed that the patients' abilities to function in daily life also improved significantly of the 4-year study period.

Furthermore, 40% of patients were in employment at the end of the study period compared with just 21% at the start.

The team also found that patients with a shorter duration of untreated psychosis at the start of the study and those who had spent more time in education showed greater improvements than other patients.

Dr O'Callaghan and team conclude: "The outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness."
They add: "This study supports the relationship between duration of untreated psychosis and outcome beyond the early stages of illness."

The research is published in the journal Psychological Medicine.