Optimizing the early prediction model for symptomatic remission with short-term treatment for schizophrenia.

Remission seems achievable for a portion of schizophrenic patients. This study aimed to identify the early predictors for remission and to establish an optimal prediction model. One hundred thirty-five acutely ill schizophrenic inpatients received 150-mg/d zotepine treatment for 4 weeks. Psychopathologic severity was assessed weekly using the Brief Psychiatric Rating Scale (BPRS). Symptomatic remission was defined according to the consensus criteria proposed by Andreasen et al. Backward stepwise logistic regression model was used to obtain the early predictors. The receiver operating characteristic curve was used to determine the cutoff point of predictors. The study was conducted from June 2004 to April 2005. Twenty-one (21.0%) of 100 completers remitted after 4 weeks of treatment. The most influential predictors for ultimate remission were percentage of BPRS score reduction at week 2 and BPRS remission-items score at week 2. Brief Psychiatric Rating Scale score reduction at week 2 of 35% and BPRS remission-items score of 18 at week 2 seemed to be the optimal cutoff points. They provided a sensitivity of 62% and 84% and a specificity of 86% and 65%. Patients with less than a 35% BPRS score reduction and a BPRS remission-items score larger than 18 during the first 2 weeks of treatment were unlikely to reach a final remission. Whether the finding can be extrapolated to other validated assessment scales and other antipsychotics require further studies.