Factors affecting outcome in schizophrenia and their relevance for psychopharmacological treatment

A. Carlo Altamura*, William V. Bobo, Herbert Y. Meltzer

*Corresponding author for this work

Research output: Contribution to journalReview article

48 Scopus citations

Abstract

A major focus of current treatment research in schizophrenia is the determinants of long-term outcome, including functional outcome and general medical well being, rather than just specific domains of psychopathology such as positive and negative symptoms, mood symptoms, and cognitive impairment. This focus does not negate the importance of the latter issues but sees them as factors contributing to long-term outcome to variable extents. A long-term treatment focus facilitates a more clinically relevant assessment of benefits versus risks of available treatments. For instance, atypical antipsychotic drugs as a group have clear advantages for several important domains of efficacy that may influence long-term outcome, but are also more expensive over the long term. Use of some agents may also result in deleterious physical health consequences as well as large additional costs over the long term owing to metabolic adverse effects. The present paper focuses on several key issues in schizophrenia which are important determinants of long-term outcome in schizophrenia, or influence choice of antipsychotic drugs, or both, including: (i) duration of untreated psychosis; (ii) impact of relapse on long-term outcome; (iii) limited efficacy for specific domains of psychopathology of current treatments; (iv) mortality owing to suicide; and (v) mortality owing to other causes (e.g. cardiovascular disease).

Original languageEnglish (US)
Pages (from-to)249-267
Number of pages19
JournalInternational Clinical Psychopharmacology
Volume22
Issue number5
DOIs
StatePublished - Sep 1 2007

Keywords

  • Atypical antipsychotics
  • Outcome
  • Relapse
  • Schizophrenia
  • Treatment resistance

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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