Abstract
Historically, schizophrenia has been associated with early-onset, persistent symptoms, and progressive decline accompanied by poor functional recovery. The advent of effective drugs in the 1950s improved symptom control, at least from the standpoint of positive features (e.g. hallucinations, delusions). However, even here the response was limited and efficacy in other symptom domains (cognitive, deficit/negative) was minimal. With clozapine as the prototype, the second-generation antipsychotics arrived in the 1990s with claims of improved tolerability, as well as greater and broader clinical efficacy, all of which was to translate to gains in functional outcome and quality of life. The capacity of these drugs to effect such changes has since been tempered, but it remains that the research and hope generated served as an impetus to redefine outcomes.
A medical-based model, centred on pharmacotherapy and symptom resolution, has given way to a re-conceptualization of schizophrenia and treatment goals. There is a clearer distinction between clinical and functional outcomes, and, with this, greater attention has been given to these other symptom domains that curtail improvement in the latter. At the same time, a concerted shift to shared decision making has underscored quality-of-life issues that benefit from, but cannot be guaranteed by, either clinical or functional improvement. To this end, the field has now embraced a recovery model that is seen as a process, multidimensional and individualized, rather than dichotomous and symptom driven.
Similar content being viewed by others
References
Kraepelin E. Dementia praecox and paraphrenia. Melbourne (VIC): Krieger Publishing Co, 1971
Bleuler E. Dementia praecox or the group of schizophrenias. New York: International Universities Press, 1950
Lopez-Munoz F, Alamo C, Cuenca E, et al. History of the discovery and clinical introduction of chlorpromazine. Ann Clin Psychiatry 2005; 17: 113–35
Kirkby KC. Social context and health consequences of the antipsychotics introduction. Ann Clin Psychiatry 2005; 17: 141–6
Andreasen NC, Olsen S. Negative v positive schizophrenia: definition and validation. Arch Gen Psychiatry 1982; 39: 789–94
Crow TJ. Positive and negative schizophrenic symptoms and the role of dopamine. Br J Psychiatry 1980; 137: 383–6
Carpenter Jr WT, Heinrichs DW, Wagman AM. Deficit and nondeficit forms of schizophrenia: the concept. Am J Psychiatry 1988; 145: 578–83
Hippius H. A historical perspective of clozapine. J Clin Psychiatry 1999; 60Suppl. 12: 22–3
Kane J, Honigfeld G, Singer J, et al. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988 Sep; 45(9): 789–96
Fleischhacker W. ‘Atypical antipsychotics’ and the semantics of psychopharmacology. Curr Opin Psychiatry 2002; 15: 1–2
Remington G, Kapur S. Atypical antipsychotics: are some more atypical than others? Psychopharmacology (Berl) 2000; 148(1): 3–15
Kapur S, Remington G. Dopamine D2 receptors and their role in atypical antipsychotic action: still necessary and may even be sufficient. Biol Psychiatry 2001; 50(11): 873–83
Remington G. Understanding antipsychotic ‘atypicality’: a clinical and pharmacological moving target. J Psychiatry Neurosci 2003; 28(4): 275–84
Jones PB, Barnes TR, Davies L, et al. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch Gen Psychiatry 2006; 63(10): 1079–87
Kahn RS, Fleischhacker WW, Boter H, et al. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet 2008; 371(9618): 1085–97
Lieberman JA, Stroup TS, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353(12): 1209–23
Elkis H. Treatment-resistant schizophrenia. Psychiatr Clin North Am 2007; 30(3): 511–33
Lewis SW, Barnes TR, Davies L, et al. Randomized controlled trial of effect of prescription of clozapine versus other second-generation antipsychotic drugs in resistant schizophrenia. Schizophr Bull 2006; 32(4): 715–23
McEvoy JP, Lieberman JA, Stroup TS, et al. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry 2006; 163(4): 600–10
Buckley PF, Stahl SM. Pharmacological treatment of negative symptoms of schizophrenia: therapeutic opportunity or cul-de-sac? Acta Psychiatr Scand 2007; 115(2): 93–100
Emsley R, Oosthuizen P. Evidence-based pharmacotherapy of schizophrenia. Int J Neuropsychopharmacol 2004; 7(2): 219–38
Marder SR. Drug initiatives to improve cognitive function. J Clin Psychiatry 2006; 67Suppl. 9: 31–5
Geddes J, Freemantle N, Harrison P, et al. Atypical anti-psychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis. BMJ 2000; 321(7273): 1371–6
Leucht S, Pitschel-Walz G, Abraham D, et al. Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo: a meta-analysis of randomized controlled trials. Schizophr Res 1999; 35(1): 51–68
Miller DD, Caroff SN, Davis SM, et al. Extrapyramidal side-effects of antipsychotics in a randomised trial. Br J Psychiatry 2008; 193(4): 279–88
Weiden PJ. EPS profiles: the atypical antipsychotics are not all the same. J Psychiatr Pract 2007; 13(1): 13–24
Correll CU, Schenk EM. Tardive dyskinesia and new antipsychotics. Curr Opin Psychiatry 2008; 21(2): 151–6
Kane JM. Tardive dyskinesia circa 2006. Am J Psychiatry 2006; 163(8): 1316–8
Voruganti LP, Baker LK, Awad AG. New generation anti-psychotic drugs and compliance behaviour. Curr Opin Psychiatry 2008; 21(2): 133–9
Agid O, Kapur S, Remington G. Emerging drugs for schizophrenia. Expert Opin Emerg Drugs 2008; 13(3): 479–95
Brewer WJ, Wood SJ, Phillips LJ, et al. Generalized and specific cognitive performance in clinical high-risk cohorts: a review highlighting potential vulnerability markers for psychosis. Schizophr Bull 2006; 32(3): 538–55
Fenton WS, McGlashan TH. Antecedents, symptom progression, and long-term outcome of the deficit syndrome in schizophrenia. Am J Psychiatry 1994; 151(3): 351–6
Hoff AL, Sakuma M, Wieneke M, et al. Longitudinal neuropsychological follow-up study of patients with first-episode schizophrenia. Am J Psychiatry 1999; 156(9): 1336–41
Kelley ME, Gilbertson M, Mouton A, et al. Deterioration in premorbid functioning in schizophrenia: a developmental model of negative symptoms in drug-free patients. Am J Psychiatry 1992; 149(11): 1543–8
Yung AR, McGorry PD. The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 1996; 22(2): 353–70
Stahl SM, Buckley PF. Negative symptoms of schizophrenia: a problem that will not go away. Acta Psychiatr Scand 2007; 115(1): 4–11
Guy W, editor. Assessment manual for psychopharmacology. Rockville (MD): National Institute of Mental Health, 1976
Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799–812
Spitzer RL, Endicott J. Schedule for affective disorders and schizophrenia-change version. 3rd ed. New York: New York State Psychiatric Institute, Biometrics Research, 1978
Leucht S, Engel RR. The relative sensitivity of the Clinical Global Impressions Scale and the Brief Psychiatric Rating Scale in antipsychotic drug trials. Neuropsychopharmacology 2006; 31: 406–12
Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13(2): 261–76
Andreasen NC. The Scale for the Assessment of Negative Symptoms (SANS). Iowa City (IA): University of Iowa, 1983
Andreasen NC. The Scale for the Assessment of Positive Symptoms (SAPS). Iowa City (IA): University of Iowa, 1984
Kirkpatrick B, Buchanan RW, McKenney PD, et al. The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatry Res 1989; 30(2): 119–23
Foussias G, Remington G. Negative symptoms in schizophrenia: avolition and Occam’s razor. Schizophr Bull. Epub 2008 Jul 21
Blanchard JJ, Horan WP, Collins LM. Examining the latent structure of negative symptoms: is there a distinct subtype of negative symptom schizophrenia? Schizophr Res 2005; 77(2–3): 151–65
Greenwood KE, Landau S, Wykes T. Negative symptoms and specific cognitive impairments as combined targets for improved functional outcome within cognitive remediation therapy. Schizophr Bull 2005; 31(4): 910–21
Ho BC, Nopoulos P, Flaum M, et al. Two-year outcome in first-episode schizophrenia: predictive value of symptoms for quality of life. Am J Psychiatry 1998; 155(9): 1196–201
Milev P, Ho BC, Arndt S, et al. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry 2005; 162(3): 495–506
Rosenheck R, Leslie D, Keefe R, et al. Barriers to employment for people with schizophrenia. Am J Psychiatry 2006; 163(3): 411–7
Kirkpatrick B, Fenton WS, Carpenter Jr WT, et al. The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull 2006; 32(2): 214–9
Emsley R, Rabinowitz J, Torreman M. The factor structure for the Positive and Negative Syndrome Scale (PANSS) in recent-onset psychosis. Schizophr Res 2003; 61(1): 47–57
Harvey PD, Green MF, Keefe RS, et al. Cognitive functioning in schizophrenia: a consensus statement on its role in the definition and evaluation of effective treatments for the illness. J Clin Psychiatry 2004; 65(3): 361–72
Kremen WS, Seidman LJ, Faraone SV, et al. The paradox of normal neuropsychological function in schizophrenia. J Abnorm Psychol 2000; 109(4): 743–52
Palmer BW, Heaton RK, Paulsen JS, et al. Is it possible to be schizophrenic yet neuropsychologically normal? Neuropsychology 1997; 11(3): 437–46
Murray RM, Lappin J, Di Forti M. Schizophrenia: from developmental deviance to dopamine dysregulation. Eur Neuropsychopharmacol 2008; 18Suppl. 3: S129–34
Ostrom TM. The sovereignty of social cognition. In: Wyer RS, Srull TK, editors. Handbook of social cognition. Hillsdale (NJ): Erlbaum, 1984: 1–37
Bertrand MC, Sutton H, Achim AM, et al. Social cognitive impairments in first episode psychosis. Schizophr Res 2007; 95(1–3): 124–33
Brekke JS, Hoe M, Long J, et al. How neurocognition and social cognition influence functional change during community-based psychosocial rehabilitation for individuals with schizophrenia. Schizophr Bull 2007; 33(5): 1247–56
Pijnenborg GH, Withaar FK, Evans JJ, et al. The predictive value of measures of social cognition for community functioning in schizophrenia: implications for neuropsychological assessment. J Int Neuropsychol Soc 2009; 15(2): 239–47
Meyer MB, Kurtz MM. Elementary neurocognitive function, facial affect recognition and social-skills in schizophrenia. Schizophr Res 2009; 110(1–3): 173–9
Corcoran R, Mercer G, Frith CD. Schizophrenia, symptomatology and social inference: investigating ‘theory of mind’ in people with schizophrenia. Schizophr Res 1995; 17(1): 5–13
Sergi MJ, Green MF, Widmark C, et al. Social cognition and neurocognition: effects of risperidone, olanzapine, and haloperidol. Am J Psychiatry 2007; 164(10): 1585–92
Green MF, Nuechterlein KH. The MATRICS initiative: developing a consensus cognitive battery for clinical trials. Schizophr Res 2004; 72(1): 1–3
Marder SR, Fenton W. Measurement and treatment research to improve cognition in schizophrenia: NIMH MATRICS initiative to support the development of agents for improving cognition in schizophrenia. Schizophr Res 2004; 72(1): 5–9
Buckley PF, Miller BJ, Lehrer DS, et al. Psychiatric comorbidities and schizophrenia. Schizophr Bull 2009; 35(2): 383–402
Addington D, Addington J, Schissel B. A depression rating scale for schizophrenics. Schizophr Res 1990; 3(4): 247–51
Collins AA, Remington G, Coulter K, et al. Depression in schizophrenia: a comparison of three measures. Schizophr Res 1996; 20(1–2): 205–9
Bassett AS, Bury A, Honer WG. Testing Liddle’s three-syndrome model in families with schizophrenia. Schizophr Res 1994; 12(3): 213–21
Dollfus S, Everitt B, Ribeyre JM, et al. Identifying subtypes of schizophrenia by cluster analyses. Schizophr Bull 1996; 22(3): 545–55
van der Gaag M, Cuijpers A, Hoffman T, et al. The five-factor model of the Positive and Negative Syndrome Scale: I. Confirmatory factor analysis fails to confirm 25 published five-factor solutions. Schizophr Res 2006; 85(1–3): 273–9
Fleischhacker WW, Kemmler G. The clinical relevance of percentage improvements on the PANSS score. Neuropsychopharmacology 2007; 32(11): 2435–6
Leucht S, Kane JM, Etschel E, et al. Linking the PANSS, BPRS, and CGI: clinical implications. Neuropsychopharmacology 2006; 31(10): 2318–25
Leucht S, Davis JM, Engel RR, et al. Defining ‘response’ in antipsychotic drug trials: recommendations for the use of scale-derived cutoffs. Neuropsychopharmacology 2007; 32(9): 1903–10
Patel SR, Bakken S, Ruland C. Recent advances in shared decision making for mental health. Curr Opin Psychiatry 2008; 21(6): 606–12
Shumway M, Saunders T, Shern D, et al. Preferences for schizophrenia treatment outcomes among public policy makers, consumers, families, and providers. Psychiatr Serv 2003; 54(8): 1124–8
Green MF, Kern RS, Braff DL, et al. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ‘right stuff’? Schizophr Bull 2000; 26(1): 119–36
McGurk SR, Mueser KT, Harvey PD, et al. Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment. Psychiatr Serv 2003; 54(8): 1129–35
Lehman AF, Carpenter Jr WT, Goldman HH, et al. Treatment outcomes in schizophrenia: implications for practice, policy, and research. Schizophr Bull 1995; 21(4): 669–75
Bustillo JR, Lauriello J, Keith SJ. Schizophrenia: improving outcome. Harv Rev Psychiatry 1999; 6(5): 229–40
Mortimer AM. Cognitive function in schizophrenia: do neuroleptics make a difference? Pharmacol Biochem Behav 1997; 56(4): 789–95
Danion JM, Rein W, Fleurot O. Improvement of schizophrenic patients with primary negative symptoms treated with amisulpride. Am J Psychiatry 1999; 156(4): 610–6
Moller HJ. Novel antipsychotics and negative symptoms. Int Clin Psychopharmacol 1998; 13Suppl. 3: S43–7
Schmidt CJ, Sorensen SM, Kehne JH, et al. The role of 5-HT2A receptors in antipsychotic activity. Life Sci 1995; 56(25): 2209–22
Villeneuve A. Pathophysiology and treatment of negative symptoms. Can J Psychiatry 1994; 39 Suppl. 2: S53–8
Gallhofer B, Bauer U, Lis S, et al. Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs. Eur Neuropsychopharmacol 1996; 6Suppl. 2: S13–20
Sharma T, Mockler D. The cognitive efficacy of atypical antipsychotics in schizophrenia. J Clin Psychopharmacol 1998; 18Suppl. 1: 12S–9S
Tollefson GD. Cognitive function in schizophrenic patients. J Clin Psychiatry 1996; 57Suppl. 11: 31–9
Keefe RS, Bilder RM, Davis SM, et al. Neurocognitive effects of antipsychotic medications in patients with chronic schizophrenia in the CATIE trial. Arch Gen Psychiatry 2007; 64(6): 633–47
Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996; 153(3): 321–30
Harvey PD, Koren D, Reichenberg A, et al. Negative symptoms and cognitive deficits: what is the nature of their relationship? Schizophr Bull 2006; 32(2): 250–8
Gray JA, Roth BL. The pipeline and future of drug development in schizophrenia. Mol Psychiatry 2007; 12(10): 904–22
Gray JA, Roth BL. Molecular targets for treating cognitive dysfunction in schizophrenia. Schizophr Bull 2007; 33(5): 1100–19
Laughren T, Levin R. Food and Drug Administration perspective on negative symptoms in schizophrenia as a target for a drug treatment claim. Schizophr Bull 2006; 32(2): 220–2
Lieberman JA. What the CATIE study means for clinical practice. Psychiatr Serv 2006; 57(8): 1075
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994
Burlingame GM, Dunn TW, Chen S, et al. Selection of outcome assessment instruments for inpatients with severe and persistent mental illness. Psychiatr Serv 2005; 56(4): 444–51
Heinrichs DW, Hanlon TE, Carpenter Jr WT. The quality of life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984; 10(3): 388–98
Mausbach BT, Moore R, Bowie C, et al. A review of instruments for measuring functional recovery in those diagnosed with psychosis. Schizophr Bull 2008; 35(2): 307–18
Patterson TL, Goldman S, McKibbin CL, et al. UCSD performance-based skills assessment: development of a new measure of everyday functioning for severely mentally ill adults. Schizophr Bull 2001; 27(2): 235–45
Harvey PD, Velligan DI, Bellack AS. Performance-based measures of functional skills: usefulness in clinical treatment studies. Schizophr Bull 2007; 33(5): 1138–48
Lehman AF. Measures of quality of life among persons with severe and persistent mental disorders. Soc Psychiatry Psychiatr Epidemiol 1996; 31(2): 78–88
Lehman AF. Quality of life issues and assessment among persons with schizophrenia. In: Moscarelli M, Rupp A, Sartorius N, editors. Handbook of mental health economics and health policy. Chichester: John Wiley & Sons, 1996: 69–79
Davidson L, O’Connell M, Tondora J, et al. The top ten concerns about recovery encountered in mental health system transformation. Psychiatr Serv 2006; 57(5): 640–5
Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med 1983; 13(1): 177–83
Cramer J, Rosenheck R, Xu W, et al. Detecting improvement in quality of life and symptomatology in schizophrenia. Schizophr Bull 2001; 27(2): 227–34
Mohamed S, Rosenheck R, Swartz M, et al. Relationship of cognition and psychopathology to functional impairment in schizophrenia. Am J Psychiatry 2008; 165(8): 978–87
Narvaez JM, Twamley EW, McKibbin CL, et al. Subjective and objective quality of life in schizophrenia. Schizophr Res 2008; 98(1–3): 201–8
Hennekens CH, Hennekens AR, Hollar D, et al. Schizophrenia and increased risks of cardiovascular disease. Am Heart J 2005; 150(6): 1115–21
Remington G. Schizophrenia, antipsychotics, and the metabolic syndrome: is there a silver lining? Am J Psychiatry 2006; 163(7): 1132–4
Nasrallah HA, Targum SD, Tandon R, et al. Defining and measuring clinical effectiveness in the treatment of schizophrenia. Psychiatr Serv 2005; 56(3): 273–82
Harvey K, Catty J, Langman A, et al. A review of instruments developed to measure outcomes for carers of people with mental health problems. Acta Psychiatr Scand 2008; 117(3): 164–76
Zubin J, Steinhauer S, Condray R. Vulnerability to relapse in schizophrenia. Br J Psychiatry Suppl 1992; 18: 13–8
Lader M. What is relapse in schizophrenia? Int Clin Psychopharmacol 1995; 9Suppl. 5: 5–9
Leucht S, Barnes TR, Kissling W, et al. Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomized, controlled trials. Am J Psychiatry 2003; 160(7): 1209–22
Kane JM, Leucht S. Unanswered questions in schizophrenia clinical trials. Schizophr Bull 2008; 34(2): 302–9
Mouaffak F, Tranulis C, Gourevitch R, et al. Augmentation strategies of clozapine with antipsychotics in the treatment of ultraresistant schizophrenia. Clin Neuropharmacol 2006; 29(1): 28–33
Remington G, Saha A, Chong SA, et al. Augmentation strategies in clozapine-resistant schizophrenia. CNS Drugs 2005; 19(10): 843–72
Beitinger R, Lin J, Kissling W, et al. Comparative remission rates of schizophrenic patients using various remission criteria. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32(7): 1643–51
Leucht S, Beitinger R, Kissling W. On the concept of remission in schizophrenia. Psychopharmacology (Berl) 2007; 194(4): 453–61
Andreasen NC. Standardized remission criteria in schizophrenia. Acta Psychiatr Scand 2006; 113(2): 81
Addington J, Addington D. Symptom remission in first episode patients. Schizophr Res 2008; 106(2–3): 281–5
Gasquet I, Haro JM, Tcherny-Lessenot S, et al. Remission in the outpatient care of schizophrenia: 3-year results from the Schizophrenia Outpatients Health Outcomes (SOHO) study in France. Eur Psychiatry 2008; 23(7): 491–6
Lambert M, Schimmelmann BG, Naber D, et al. Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry 2006; 67(11): 1690–7
Novick D, Haro JM, Suarez D, et al. Symptomatic remission in previously untreated patients with schizophrenia: 2-year results from the SOHO study. Psychopharmacology (Berl) 2007; 191(4): 1015–22
Petersen L, Thorup A, Oqhlenschlaeger J, et al. Predictors of remission and recovery in a first-episode schizophrenia spectrum disorder sample: 2-year follow-up of the OPUS trial. Can J Psychiatry 2008; 53(10): 660–70
San L, Ciudad A, Alvarez E, et al. Symptomatic remission and social/vocational functioning in outpatients with schizophrenia: prevalence and associations in a cross-sectional study. Eur Psychiatry 2007; 22(8): 490–8
De Hert M, van Winkel R, Wampers M, et al. Remission criteria for schizophrenia: evaluation in a large naturalistic cohort. Schizophr Res 2007; 92(1–3): 68–73
van Os J, Drukker M, a Campo J, et al. Validation of remission criteria for schizophrenia. Am J Psychiatry 2006; 163(11): 2000–2
Lasser RA, Nasrallah H, Helldin L, et al. Remission in schizophrenia: applying recent consensus criteria to refine the concept. Schizophr Res 2007; 96(1–3): 223–31
Boden R, Sundstrom J, Lindstrom E, et al. Association between symptomatic remission and functional outcome in first-episode schizophrenia. Schizophr Res 2008; 107(2–3): 232–7
Helldin L, Kane JM, Karilampi U, et al. Remission in prognosis of functional outcome: a new dimension in the treatment of patients with psychotic disorders. Schizophr Res 2007; 93(1–3): 160–8
Del Vecchio P. Commentary: all we are saying is give people with mental illnesses a chance. Psychiatr Serv 2006; 57(5): 646
Dickerson FB. Commentary: disquieting aspects of the recovery paradigm. Psychiatr Serv 2006; 57(5): 647
Harrow M, Jobe TH. Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: a 15-year multi-follow-up study. J Nerv Ment Dis 2007; 195(5): 406–14
Liberman RP, Kopelowicz A. Recovery from schizophrenia: a concept in search of research. Psychiatr Serv 2005; 56(6): 735–42
Piat M, Sabetti J, Couture A. Do consumers use the word ‘recovery’? Psychiatr Serv 2008; 59(4): 446–7
President’s New Freedom Commission on Mental Health. Achieving the promise: transfoming mental health care in America. Rockville (MD): US Department of Health and Human Services, 2006 [online]. Available from URL: http://www.mentalhealthcommission.gov [Accessed 2009 Oct 21]
Remington G, Kapur S. Remission: what’s in a name? Am J Psychiatry 2005; 162(12): 2393–4
McGlashan TH. At issue: is natural selection rendering schizophrenia less severe? Schizophr Bull 2006; 32(3): 428–9
Faerden A, Nesvag R, Marder SR. Definitions of the term ‘recovered’ in schizophrenia and other disorders. Psychopathology 2008; 41(5): 271–8
McEvoy JP. Functional outcomes in schizophrenia. J Clin Psychiatry 2008; 69Suppl. 3: 20–4
Schooler NR. Relapse prevention and recovery in the treatment of schizophrenia. J Clin Psychiatry 2006; 67Suppl. 5: 19–23
Salyers MP, Godfrey JL, Mueser KT, et al. Measuring illness management outcomes: a psychometric study of clinician and consumer rating scales for illness self management and recovery. Community Ment Health J 2007; 43(5): 459–80
Leucht S, Lasser R. Theconcepts of remission and recovery in schizophrenia. Pharmacopsychiatry 2006; 39(5): 161–70
Agid O, Remington G, Kapur S, et al. Early use of clozapine for poorly responding first-episode psychosis. J Clin Psychopharmacol 2007; 27(4): 369–73
Harrow M, Jobe TH. Longitudinal studies of outcome and recovery in schizophrenia and early intervention: can they make a difference? Can J Psychiatry 2005; 50(14): 879–80
Ahmed M, Osser DN, Boisvert CM, et al. Rationale for emphasis on management over treatment of schizophrenia in clinical practice. Ann Pharmacother 2007; 41(4): 693–5
Masand PS, Narasimhan M. Improving adherence to antipsychotic pharmacotherapy. Curr Clin Pharmacol 2006; 1(1): 47–56
Naber D. Subjective effects of antipsychotic drugs and their relevance for compliance and remission. Epidemiol Psychiatr Soc 2008; 17(3): 174–6
Perkins DO, Johnson JL, Hamer RM, et al. Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode. Schizophr Res 2006; 83(1): 53–63
Malla AK, Norman RM, Joober R. First-episode psychosis, early intervention, and outcome: what have we learned? Can J Psychiatry 2005; 50(14): 881–91
Demily C, Franck N. Cognitive remediation: a promising tool for the treatment of schizophrenia. Expert Rev Neurother 2008; 8(7): 1029–36
Brown PC, Tucker WM. Measuring the effectiveness of outpatient care. Psychiatr Serv 2005 Mar; 56(3): 241
Dickerson FB, Brown CH, Daumit GL, et al. Health status of individuals with serious mental illness. Schizophr Bull 2006; 32(3): 584–9
Jobe TH, Harrow M. Long-term outcome of patients with schizophrenia: a review. Can J Psychiatry 2005; 50(14): 892–900
Robinson DG, Woerner MG, McMeniman M, et al. Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 2004; 161(3): 473–9
Acknowledgements
No sources of funding were used to assist in the preparation of this review. Dr Remington has received grant support from Novartis, and acted in a consultant role for Cannasat Therapeutics Inc., Impax Laboratories Inc. and Medicure Inc. In the past 5 years, Dr Agid has received speaker honoraria from Eli Lilly and Janssen-Ortho. Dr Foussias has no conflicts of interest that are directly relevant to the content of this review.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Remington, G., Foussias, G. & Agid, O. Progress in Defining Optimal Treatment Outcome in Schizophrenia. CNS Drugs 24, 9–20 (2010). https://doi.org/10.2165/11530250-000000000-00000
Published:
Issue Date:
DOI: https://doi.org/10.2165/11530250-000000000-00000