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What happens with schizophrenia patients after their discharge from hospital? Results on outcome and treatment from a “real-world” 2-year follow-up trial

  • Rebecca SchennachEmail author
  • Michael Riedel
  • Michael Obermeier
  • Markus Jäger
  • Max Schmauss
  • Gerd Laux
  • Herbert Pfeiffer
  • Dieter Naber
  • Lutz G. Schmidt
  • Wolfgang Gaebel
  • Joachim Klosterkötter
  • Isabella Heuser
  • Wolfgang Maier
  • Matthias R. Lemke
  • Eckart Rüther
  • Stefan Klingberg
  • Markus Gastpar
  • Florian Seemüller
  • Ilja Spellmann
  • Richard Musil
  • Hans-Jürgen Möller
Original Paper

Abstract

Aim of the study was to examine the course of schizophrenia patients within 2 years after discharge. Within a multicenter study of the German Competence Network on Schizophrenia, patients suffering from a schizophrenia spectrum disorder were examined regarding their psychopathological improvement, tolerability, and the treatment regime applied during hospitalization and a 2-year follow-up period. Response, remission, the level of everyday functioning, and relapse were furthermore evaluated during the follow-up period using established definitions for these outcome domains. The psychopharmacological treatment was specifically evaluated in terms of a potential association with relapse. 149 patients were available for analysis, with 65% of the patients being in response, 52% in symptomatic remission, and 64% having a satisfiable everyday functioning 2 years after their discharge from hospital. Despite these favorable outcome rates, 63% of the patients suffered from a relapse within the 2-year follow-up period with 86% of these patients being rehospitalized. Discharge non-responder and non-remitter were twice as likely to relapse during follow-up. A significant decrease of side-effects was observed with negligible rates of extrapyramidal side-effects, sedation, and weight gain during follow-up. Patients receiving treatment with atypical antipsychotics were found to have the lowest risk to relapse (p < 0.0001). The results highlight the natural and unsteady course of schizophrenia in most patients underlining the need to develop more specific treatment strategies ensuring ongoing stability and preventing relapse.

Keywords

Schizophrenia Response Remission Functioning Relapse 2-year follow-up 

Notes

Funding

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 01 GI 0233).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest within the context of this study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Rebecca Schennach
    • 1
    • 2
    Email author
  • Michael Riedel
    • 1
    • 16
  • Michael Obermeier
    • 1
  • Markus Jäger
    • 1
    • 17
  • Max Schmauss
    • 3
  • Gerd Laux
    • 4
  • Herbert Pfeiffer
    • 5
  • Dieter Naber
    • 6
  • Lutz G. Schmidt
    • 7
  • Wolfgang Gaebel
    • 8
  • Joachim Klosterkötter
    • 9
  • Isabella Heuser
    • 10
  • Wolfgang Maier
    • 11
  • Matthias R. Lemke
    • 12
  • Eckart Rüther
    • 13
  • Stefan Klingberg
    • 14
  • Markus Gastpar
    • 15
  • Florian Seemüller
    • 1
  • Ilja Spellmann
    • 1
    • 18
  • Richard Musil
    • 1
  • Hans-Jürgen Möller
    • 1
  1. 1.Department of Psychiatry and PsychotherapyLudwig-Maximilians-UniversityMunichGermany
  2. 2.Schoen Clinic RoseneckPrien am ChiemseeGermany
  3. 3.Psychiatric ClinicDistrict Hospital AugsburgAugsburgGermany
  4. 4.Psychiatric ClinicInn-Salzach HospitalWasserburg/InnGermany
  5. 5.Psychiatric ClinicIsar-Amper HospitalMunich-HaarGermany
  6. 6.Department of Psychiatry and PsychotherapyUniversity of HamburgHamburgGermany
  7. 7.Department of Psychiatry and PsychotherapyUniversity of MainzMainzGermany
  8. 8.Department of Psychiatry and Psychotherapy, Medical FacultyHeinrich-Heine-University DuesseldorfDuesseldorfGermany
  9. 9.Department of Psychiatry and PsychotherapyUniversity of CologneCologneGermany
  10. 10.Department of Psychiatry and PsychotherapyCharite BerlinBerlinGermany
  11. 11.Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
  12. 12.Department of PsychiatryAlsterdorf HospitalHamburgGermany
  13. 13.Department of Psychiatry and PsychotherapyUniversity of GöttingenGöttingenGermany
  14. 14.Department of Psychiatry and PsychotherapyUniversity of TübingenTübingenGermany
  15. 15.Department of Psychiatry and PsychotherapyUniversity of EssenEssenGermany
  16. 16.Psychiatric ClinicSächsisches Krankenhaus RodewischRodewischGermany
  17. 17.Department of Psychiatry and PsychotherapyBezirkskrankenhaus KemptenKemptenGermany
  18. 18.Department of Special Psychiatry, Social Psychiatry and PsychotherapyKlinikum StuttgartStuttgartGermany

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