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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

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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.

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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).

Author information

Authors and Affiliations

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

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

  2. Schoen Clinic Roseneck, Am Roseneck 6, 83209, Prien am Chiemsee, Germany

    Rebecca Schennach

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

    Max Schmauss

  4. Psychiatric Clinic, Inn-Salzach Hospital, Wasserburg/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 Duesseldorf, Duesseldorf, 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. Psychiatric Clinic, Sächsisches Krankenhaus Rodewisch, Rodewisch, Germany

    Michael Riedel

  17. Department of Psychiatry and Psychotherapy, Bezirkskrankenhaus Kempten, Kempten, Germany

    Markus Jäger

  18. Department of Special Psychiatry, Social Psychiatry and Psychotherapy, Klinikum Stuttgart, Stuttgart, Germany

    Ilja Spellmann

Authors
  1. Rebecca Schennach
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  2. Michael Riedel
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  3. Michael Obermeier
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  4. Markus Jäger
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  5. Max Schmauss
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  8. Dieter Naber
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  9. Lutz G. Schmidt
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  12. Isabella Heuser
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  14. Matthias R. Lemke
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  15. Eckart Rüther
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  16. Stefan Klingberg
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  17. Markus Gastpar
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  18. Florian Seemüller
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  19. Ilja Spellmann
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  20. Richard Musil
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  21. Hans-Jürgen Möller
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Corresponding author

Correspondence to Rebecca Schennach.

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

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Schennach, R., Riedel, M., Obermeier, M. et al. What happens with schizophrenia patients after their discharge from hospital? Results on outcome and treatment from a “real-world” 2-year follow-up trial. Eur Arch Psychiatry Clin Neurosci 270, 661–671 (2020). https://doi.org/10.1007/s00406-019-01055-4

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  • DOI: https://doi.org/10.1007/s00406-019-01055-4

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