Nasrallah Henry A, Lasser Rob
University of Cincinnati College of Medicine, Cincinnati, OH 45267-0599, USA.
J Psychopharmacol. 2006 Nov;20(6 Suppl):57-61. doi: 10.1177/1359786806071248.
The Remission in Schizophrenia Working Group has recently proposed a consensus definition of remission in schizophrenia and, based on this definition, has developed specific operational criteria for the assessment of remission. The aim of this article was to assess the application of these consensus criteria and to discuss the barriers for achieving remission. An electronic literature search of studies published between January 1990 and December 2005 examining the concepts of remission, compliance and patient satisfaction in schizophrenia was performed using Medline and EMBASE. The primary research parameters were 'schizophrenia', 'remission', 'antipsychotics', 'atypicals' and 'conventional'. Abstracts and posters presented at key psychiatry congresses during this period were also reviewed, where available in the public domain. To date, the remission criteria have been applied retrospectively to a number of clinical studies, and these have demonstrated that the proposed definition of remission correlates significantly with established measures of symptom severity, functioning and quality of life, and appears achievable and sustainable for a significant proportion of patients receiving pharmacotherapy. The atypical antipsychotic agents have been shown to impact favourably upon certain factors that play an integral part in the achievement of remission, such as negative symptoms, cognitive impairment, social functioning and quality of life. However, non-compliance with medication remains widespread due to illness-, treatment- and clinician-related factors. The use of long-acting antipsychotic agents, with their assured medication delivery, may facilitate compliance and improve long-term treatment outcomes, possibly assisting patients in achieving remission. Remission may, therefore, be considered as a current goal of treatment today, not a distant future aim.
精神分裂症缓解工作组最近提出了精神分裂症缓解的共识定义，并基于此定义制定了评估缓解的具体操作标准。本文旨在评估这些共识标准的应用，并讨论实现缓解的障碍。使用Medline和EMBASE对1990年1月至2005年12月期间发表的研究进行了电子文献检索，这些研究探讨了精神分裂症的缓解、依从性和患者满意度概念。主要研究参数为“精神分裂症”“缓解”“抗精神病药”“非典型药物”和“传统药物”。还审查了在此期间主要精神病学大会上发表的摘要和海报（如有公开资料）。迄今为止，缓解标准已被回顾性应用于多项临床研究，这些研究表明，所提出的缓解定义与既定的症状严重程度、功能和生活质量测量指标显著相关，并且对于接受药物治疗的相当一部分患者来说似乎是可以实现和维持的。非典型抗精神病药物已被证明对实现缓解不可或缺的某些因素有积极影响，如阴性症状、认知障碍、社会功能和生活质量。然而，由于疾病、治疗和临床医生相关因素，不遵医嘱服药的情况仍然普遍存在。使用长效抗精神病药物，因其能确保药物递送，可能会促进依从性并改善长期治疗效果，可能有助于患者实现缓解。因此，缓解可被视为当今治疗的当前目标，而非遥远的未来目标。
