Premium
Trajectories of antipsychotic response in drug‐naive schizophrenia patients: results from the 6‐month ESPASS follow‐up study
Author(s) -
Nordon C.,
Rouillon F.,
Azorin J. M.,
Barry C.,
Urbach M.,
Falissard B.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12135
Subject(s) - antipsychotic drug , schizophrenia (object oriented programming) , antipsychotic , drug naïve , psychiatry , drug , medicine , psychology , clinical psychology
Objective The aim of this study was to explore any heterogeneity in the 6‐month clinical response in patients with antipsychotic drug‐naive schizophrenia and to determine predictors of that outcome. Method 467 patients with antipsychotic drug‐naive schizophrenia were included in France nationwide and followed up over 6 months. To identify trajectories of clinical response, a latent class growth analysis (LCGA) was performed using the C linical G lobal I mpression‐ S everity ( CGI ‐ S ) scores at baseline, 1, 3, and 6 months. Regression models were used to identify predictors of trajectory membership. Results Five trajectory groups were identified: a rapid response group ( n = 45), a gradual response group ( n = 204), patients remaining mildly ill ( n = 133), patients remaining very ill ( n = 23), and a group with unsustained clinical response ( n = 62). Predictors of the 6‐month clinical response were baseline CGI ‐ S score (odds ratio: 3.1; 95% confidence interval, 2.1–4.4) and negative symptoms ( OR , 1.5; 95% CI , 1.2–1.9). The sole predictor of rapid response as compared to gradual response was employment ( OR , 2.5; 95% CI , 1.2–4.9). Conclusion Clinical response in patients with schizophrenia 6 months after a first‐ever antipsychotic drug initiation is heterogeneous. Therapeutic strategies in first episode should take account of symptom severity and early clinical response, to maximize the chances of recovery.