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What are residual symptoms in schizophrenia spectrum disorder? Clinical description and 1-year persistence within a naturalistic trial

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Abstract

The aim of this study was to evaluate residual symptoms in patients achieving remission according to the consensus criteria and to analyze their potential influence on the patient’s outcome one year after discharge. In total, 399 patients suffering from a schizophrenia spectrum disorder were evaluated within a naturalistic study. Remission status was examined using the consensus criteria. Residual symptoms were defined as any symptom present at the time-point of remission following analogous analyses performed in depressed patients. Therefore, a PANSS item with a symptom severity of >1 (= at least borderline mentally ill) was defined to be a residual symptom. Remitters with and without residual symptoms were compared regarding psychopathology, functioning and side effects. In total, 236 patients (59 %) were remitters at discharge with 94 % of them suffering from at least one residual symptom. The most common residual symptoms were blunted affect (49 %), conceptual disorganization (42 %) and social withdrawal (40 %). A significant association was found between the presence of residual symptoms and the severity of side effects (p < 0.0001) and functioning (p = 0.0003) at discharge as well as between residual symptoms and the risk of relapse and chance of remission one year after discharge. Residual symptoms were highly prevalent in remitted schizophrenia inpatients following the suggested definition. Most residual symptoms were persistent baseline symptoms suggesting an ongoing illness severity. Also, the necessity to re-evaluate the consensus criteria questioning the status of remission in these patients is also pointed out.

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Acknowledgments

The study was performed within the framework of the German Research Network on Schizophrenia, which is funded by the German Federal Ministry for Education and research BMBF (Grant No. 01 GI 0233). The authors thank all those who were involved in the study, especially the colleagues at the 14 psychiatric hospitals the study was conducted at.

Conflict of interest

There is no financial conflict of interests to report within the context of this article.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstrasse 7, 80336, Munich, Germany

    Rebecca Schennach, Michael Riedel, Michael Obermeier, Ilja Spellmann, Richard Musil, Markus Jäger & Hans-Jürgen Möller

  2. Psychiatric Clinic, Vinzenz-von-Paul-Hospital, Rottweil, Germany

    Michael Riedel

  3. Psychiatric Clinic, District Hospital Augsburg, Augsburg, Germany

    Max Schmauss

  4. Psychiatric Clinic, Inn-Salzach Hospital, Wasserburg am Inn, Germany

    Gerd Laux

  5. Psychiatric Clinic, Isar-Amper Hospital, Munich-Haar, Germany

    Herbert Pfeiffer

  6. Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany

    Dieter Naber

  7. Department of Psychiatry and Psychotherapy, University of Mainz, Mainz, Germany

    Lutz G. Schmidt

  8. Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Dusseldorf, Düsseldorf, Germany

    Wolfgang Gaebel

  9. Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany

    Joachim Klosterkötter

  10. Department of Psychiatry and Psychotherapy, Charite Berlin, Campus Benjamin Franklin, Berlin, Germany

    Isabella Heuser

  11. Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

    Wolfgang Maier

  12. Department of Psychiatry, Alsterdorf Hospital, Hamburg, Germany

    Matthias R. Lemke

  13. Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany

    Eckart Rüther

  14. Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany

    Stefan Klingberg

  15. Department of Psychiatry and Psychotherapy, University of Essen, Essen, Germany

    Markus Gastpar

  16. Psychosomatic Clinic, Schoen Hospital Roseneck, Prien am Chiemsee, Germany

    Rebecca Schennach

  17. GKM Therapy Research, Munich, Germany

    Michael Obermeier

  18. Psychiatric Clinic, District Hospital Kaufbeuren, Kaufbeuren, Germany

    Ilja Spellmann

Authors
  1. Rebecca Schennach
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  2. Michael Riedel
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  7. Max Schmauss
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  8. Gerd Laux
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  9. Herbert Pfeiffer
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  10. Dieter Naber
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  11. Lutz G. Schmidt
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  14. Isabella Heuser
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  15. Wolfgang Maier
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  18. Stefan Klingberg
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  19. Markus Gastpar
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  20. Hans-Jürgen Möller
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Correspondence to Rebecca Schennach.

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Schennach, R., Riedel, M., Obermeier, M. et al. What are residual symptoms in schizophrenia spectrum disorder? Clinical description and 1-year persistence within a naturalistic trial. Eur Arch Psychiatry Clin Neurosci 265, 107–116 (2015). https://doi.org/10.1007/s00406-014-0528-2

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  • DOI: https://doi.org/10.1007/s00406-014-0528-2

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