Clinical and psychosocial remission in schizophrenia: correlations with antipsychotic treatment

Background: Clinical and psychosocial remission amongst persons with schizophrenia is nowadays a defined goal of treatment. This necessitates incorporating quantifiable psychosocial variables with traditional symptomatic data. We aimed to assess clinical and psychosocial remission in schizophrenia in a large cohort of community dwelling persons with schizophrenia. We emphasized between-groups comparison of antipsychotic medications and administration methods on the outcome of remission. Methods: Psychiatric case managers rated psychosocial remission using the PsychoSocial Remission Scale (PSRS) and clinical remission using the Remission in Schizophrenia Working Group symptomatic remission criteria (RSWG). Ratings were performed for persons with schizophrenia they have been treating for 6 months or more. Data as to gender, age and pharmacological treatment of each patient were also collected. Results: Of 445 participants who completed the survey, 268 (60%) were evaluated by psychiatrists, 161 (36%) by nurses and 16 (4%) were evaluated by social workers. Patients mean age was 43.4 +/- 13.1 years; 61% were men and 39% were women. Antipsychotic treatments were as follows: Per-os (PO) 243 (55%), IM long-acting typical antipsychotics (LAT) 102 (23%) and IM long-acting risperidone (RLAI; Consta) 100 (22%). Overall, 37% of patients achieved symptomatic remission and 31% achieved psychosocial remission. Rates of symptomatic remission were significantly higher in patients treated by LAT and RLAI compared with PO (51% and 48% vs., 29% respectively, p = 0.0003). Rates of psychosocial remission were also significantly higher in patients treated by LAT and RLAI compared with PO (43%% and 41% vs., 24% respectively, p = 0.003). Conclusion: In a large national sample a third of persons with schizophrenia were in remission. IM long acting preparations were associated with higher remission rates. Treatment choice may thus influence rates of remission in persons with schizophrenia.