Haro J M, Novick D, Suarez D, Ochoa S, Roca M
Sant Joan de Déu-SSM, Fundació Sant Joan de Déu, CIBER-SAM, Spain.
Prog Neuropsychopharmacol Biol Psychiatry. 2008 Jul 1;32(5):1287-92. doi: 10.1016/j.pnpbp.2008.04.003. Epub 2008 Apr 9.
The course of schizophrenia includes a combination of periods of remission and relapse. Previous studies focused on simple dichotomous outcomes and did not take into account the complexity of the course. Using data from a large 3-year follow-up study of schizophrenia, we described the different courses of schizophrenia. Of the 5950 patients with complete 3-year data, 38.7% never achieved remission (prolonged course), 15.7% achieved remission but relapsed and 45.7% achieved and maintained remission (persistent remission). Females, patients with better social functioning at baseline (living independently, in paid employment, socially active or having a spouse or partner) and with a shorter duration of illness had a more favourable course. Patients prescribed risperidone, quetiapine or depot typicals at the baseline visit were more likely to have a prolonged course than patients who started olanzapine. The results show that description of the long-term outcome of schizophrenia cannot be summarized with just one outcome variable.
精神分裂症的病程包括缓解期和复发期的结合。以往的研究集中在简单的二分结果上，没有考虑到病程的复杂性。利用一项针对精神分裂症患者的大型3年随访研究的数据，我们描述了精神分裂症的不同病程。在5950例有完整3年数据的患者中，38.7%从未达到缓解（病程迁延），15.7%达到缓解但复发，45.7%达到并维持缓解（持续缓解）。女性、基线时社会功能较好（独立生活、有带薪工作、社交活跃或有配偶或伴侣）且病程较短的患者病程更为有利。在基线访视时接受利培酮、喹硫平或长效传统抗精神病药物治疗的患者比开始使用奥氮平的患者更有可能病程迁延。结果表明，精神分裂症的长期转归不能仅用一个结果变量来概括。
