Comment by Dr. William MacEwan
In recent years, the goals of schizophrenia management have moved beyond the traditional model of treating positive and negative symptoms to a more holistic approach that emphasizes functional recovery, psychosocial functioning and quality of life (QoL) (Juckel & Morosini. Curr Opin Psychiatry 2008;21:630-639). Indeed, over a decade ago, Naber and colleagues proposed that quality of life should be considered as important as psychopathology in managing patients with schizophrenia (Naber et al. Schizophr Res 2001;50:79-88). To be sure, achieving symptomatic remission with antipsychotic medications is the necessary first step to functional recovery (Kokaçya et al. Noro Psikiyatr Ars 2016;53:328-333), and the prevention of clinical relapses will have the greatest impact on QoL (Briggs et al. Health Qual Life Outcomes 2008;6:105-13). A caveat, however, is that clinical effectiveness alone may not necessarily translate to improvements in QoL and patient self-rated life satisfaction, as the Clinical Antipsychotic Trial of Intervention Effectiveness (CATIE) study reported (Fervaha et al. Eur Neuropsychopharmacol 2014;24:1078-1085). Read More
Presented at the American Society of Clinical Psychopharmacology (ASCP) Annual Meeting, Miami, Florida, May 29 – June 1, 2018
The first Canadian naturalistic study in patients with schizophrenia has reported high rates of remission rates and low rates of relapse with long-acting aripiprazole over a one-year period (Oluboka et al. ASCP 2018; abstract). Read More
Comment by Dr. Ofer Agid
Comment by Dr. Ashok Malla
The management of schizophrenia has traditionally focussed on a reduction in positive and negative symptoms with antipsychotic agents. However, this narrow focus does not adequately address other features that are important to patients and caregivers, such as social and occupational functioning, involvement in productive activities, and an ability to live independently. When the European Group on Functional Outcomes and Remission in Schizophrenia (EGOFORS) examined how psychiatrists, patients and caregivers viewed symptomatic remission, only 18% agreed in their assessment (Karow et al. Eur Psychiatry 2012;27:426-431). For clinicians, remission was largely defined as improvement in PANSS scores; whereas for patients, remission was characterized by good subjective well-being, and for caregivers it was a combination of improved well-being and symptom reduction.