Lambert Martin, Karow Anne, Leucht Stefan, Schimmelmann Benno G, Naber Dieter
Psychosis Centre, Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, German.
Dialogues Clin Neurosci. 2010;12(3):393-407. doi: 10.31887/DCNS.2010.12.3/mlambert.
In March 2005, the Remission in Schizophrenia Working Group (RSWG) proposed a consensus definition of symptomatic remission in schizophrenia and developed specific operational criteria for its assessment. They pointed out, however, that the validity and the relationship to other outcome dimensions required further examination. This article reviews studies on the validity, frequency, and predictors of symptomatic remission in schizophrenia and studies on patients' perspectives. These studies have demonstrated that the RSWG remission criteria appear achievable and sustainable for a significant proportion of patients, and are related to a better overall symptomatic status and functional outcome and, to a less clear extent, to a better quality of life and cognitive performance. However, achieving symptomatic remission is not automatically concurrent with an adequate status in other outcome dimensions. The results of the present review suggest that the RSWG remission criteria are valid and useful. As such, they should be consistently applied in clinical trials. However the lack of consensus definitions of functional remission and adequate quality of life hampers research on their predictive validity on these outcome dimensions. Future research should therefore search for criteria of these dimensions and test whether the RSWG remission criteria consistently predict a "good" outcome with respect to functioning and quality of life.
2005年3月,精神分裂症缓解工作组(RSWG)提出了精神分裂症症状缓解的共识定义,并制定了评估其的具体操作标准。然而,他们指出,其有效性以及与其他结局维度的关系需要进一步研究。本文回顾了关于精神分裂症症状缓解的有效性、频率和预测因素的研究以及患者观点的研究。这些研究表明,RSWG缓解标准对相当一部分患者来说似乎是可以实现和维持的,并且与更好的总体症状状态和功能结局相关,在不太明确的程度上,还与更好的生活质量和认知表现相关。然而,实现症状缓解并不自动意味着在其他结局维度上也有足够的状态。本综述结果表明,RSWG缓解标准是有效且有用的。因此,它们应在临床试验中持续应用。然而,功能缓解和足够生活质量缺乏共识定义阻碍了对其在这些结局维度上预测有效性的研究。因此,未来的研究应该寻找这些维度的标准,并测试RSWG缓解标准是否始终能预测功能和生活质量方面的“良好”结局。