Standardized Remission Criteria in Schizophrenia: Descriptive Validity and Comparability with Previously Used Outcome Measures

M. Jäger; T. Messer; G. Laux; H. Pfeiffer; D. Naber; L. G. Schmidt; W. Gaebel; J. Klosterkötter; I. Heuser; W. Maier; M. R. Lemke; E. Rüther; G. Buchkremer; M. Gastpar; M. Riedel; R. Bottlender; A. Strauß; H.-J. Möller

doi:10.1055/s-2008-1078745

Pharmacopsychiatry 2008; 41(5): 190-195
DOI: 10.1055/s-2008-1078745

Original Paper

Standardized Remission Criteria in Schizophrenia: Descriptive Validity and Comparability with Previously Used Outcome Measures

M. Jäger¹ , T. Messer² , G. Laux³ , H. Pfeiffer⁴ , D. Naber⁵ , L. G. Schmidt⁶ , W. Gaebel⁷ , J. Klosterkötter⁸ , I. Heuser⁹ , W. Maier¹⁰ , M. R. Lemke¹¹ , E. Rüther¹² , G. Buchkremer¹³ , M. Gastpar¹⁴ , M. Riedel¹ , R. Bottlender¹ , A. Strauß¹ , H.-J. Möller¹

¹Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
²Psychiatric Clinic, District Hospital,Augsburg, Germany
³Psychiatric Clinic, Inn-Salzach Hospital,Wasserburg/Gabersee, Germany
⁴Psychiatric Clinic, Isar-Amper Hospital, München-Haar, Germany
⁵Department of Psychiatry, University of Hamburg, Hamburg, Germany
⁶Department of Psychiatry, University of Mainz, Mainz, Germany
⁷Department of Psychiatry, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
⁸Department of Psychiatry, University of Cologne, Cologne, Germany
⁹Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
¹⁰Department of Psychiatry, University of Bonn, Bonn, Germany
¹¹Psychiatric Clinic, Rheinische Kliniken, Bonn, Germany
¹²Department of Psychiatry, University of Göttingen, Göttingen, Germany
¹³Department of Psychiatry, University of Tübingen, Tübingen, Germany
¹⁴Department of Psychiatry, University of Essen, Essen, Germany

Abstract

Introduction: Standardized consensus criteria for remission in schizophrenia were recently proposed. As yet, the validity of these criteria and their comparability with previously used outcome measures are unclear.

Methods: The symptom-severity component of the proposed remission criteria was applied to 288 inpatients who fulfilled the ICD-10 criteria for schizophrenia. Global functioning and psychopathological symptoms were assessed using GAF, PANSS, SANS, HAM-D and CDSS.

Results: When patients with symptom remission at discharge from hospitalization (n=158, 54.9%) were compared to those without symptom remission, significant differences were found with respect to the global functioning (GAF) and all observed psychopathological symptom dimensions. The percentage agreement with previously used outcome measures ranged between 52.6 and 80.0%, the kappa values between 0.120 and 0.594. A moderate accordance (kappa value: 0.495) was found with a Clinical Global Impression (CGI) severity score of three or less.

Discussion: The results indicate a high descriptive validity of the symptom-severity component of the proposed remission definition. However, the new criteria differ partially from previously used outcome measures. This aspect should be considered in the interpretation of clinical trials.

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References

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Correspondence

M. Jäger

Department of Psychiatry II

Ulm University

BKH Günzburg

Ludwig-Heilmeyer-Str. 2

89312 Günzburg

Germany

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Fax: +49/8221/96 27 37

eMail: Markus.Jaeger@bkh-guenzburg.de