Response and remission in schizophrenia: The limited value of new remission criteria

Object: The Remission in Schizophrenia Working Group proposed in 2005 criteria for remission in patients with schizophrenia. This composite criterion consists of eight PANSS items and is reached when none of those has a score of more than 3 during a period of 6 months. The present study was done to elucidate the clinical relevance of this concept. Method: A group of 65 patients with schizophrenia was treated with atypical antipsychotics for 14 weeks. At baseline and endpoint, severity of symptoms was assessed with the PANSS, the BPRS, a cognitive subscale derived from the PANSS, and the CGI. A reduction of at least 50% on the BPRS total score was considered to be clinically relevant. Results: At endpoint, 18 patients (28%) had a reduction of 50% or more on the BPRS and 25 patients (39%) reached the severity criterion of remission. No correlation was found between the summed scores of the remission items and those of the cognitive subscale. Remitters and non-remitters did not differ with respect to the total score on the cognitive subscale. Predictors for remission were the PANSS positive and negative sum scores and age. Remission was reached by an only marginal symptomatic improvement. Conclusions: In this patient group, remitters are still symptomatically (e.g. cognitively) impaired and definitely not recovered, which implies that the term remission should be better replaced by partial symptomatic remission.