TY - JOUR

T1 - Treatment response in psychotic patients classified according to social and clinical needs, drug side effects, and previous treatment; a method to identify functional remission

AU - Alenius, Malin

AU - Hammarlund-Udenaes, Margareta

AU - Honoré, Per Gustaf Hartvig

AU - Sundquist, Staffan

AU - Lindström, Leif

N1 - Keywords: Activities of Daily Living; Adult; Age of Onset; Aged; Antipsychotic Agents; Cross-Sectional Studies; Delusions; Drug Resistance; Female; Humans; Male; Middle Aged; Needs Assessment; Psychometrics; Psychotic Disorders; Quality of Life; Questionnaires; Recurrence; Rehabilitation, Vocational; Reproducibility of Results; Schizophrenia; Social Adjustment; Sweden; Treatment Outcome; Young Adult

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Various approaches have been made over the years to classify psychotic patients according to inadequate treatment response, using terms such as treatment resistant or treatment refractory. Existing classifications have been criticized for overestimating positive symptoms; underestimating residual symptoms, negative symptoms, and side effects; or being to open for individual interpretation. The aim of this study was to present and evaluate a new method of classification according to treatment response and, thus, to identify patients in functional remission. METHOD: A naturalistic, cross-sectional study was performed using patient interviews and information from patient files. The new classification method CANSEPT, which combines the Camberwell Assessment of Need rating scale, the Udvalg for Kliniske Undersøgelser side effect rating scale (SE), and the patient's previous treatment history (PT), was used to group the patients according to treatment response. CANSEPT was evaluated by comparison of expected and observed results. RESULTS: In the patient population (n = 123), the patients in functional remission, as defined by CANSEPT, had higher quality of life, fewer hospitalizations, fewer psychotic symptoms, and higher rate of workers than those with the worst treatment outcome. CONCLUSION: In the evaluation, CANSEPT showed validity in discriminating the patients of interest and was well tolerated by the patients. CANSEPT could secure inclusion of correct patients in the clinic or in research.

AB - BACKGROUND: Various approaches have been made over the years to classify psychotic patients according to inadequate treatment response, using terms such as treatment resistant or treatment refractory. Existing classifications have been criticized for overestimating positive symptoms; underestimating residual symptoms, negative symptoms, and side effects; or being to open for individual interpretation. The aim of this study was to present and evaluate a new method of classification according to treatment response and, thus, to identify patients in functional remission. METHOD: A naturalistic, cross-sectional study was performed using patient interviews and information from patient files. The new classification method CANSEPT, which combines the Camberwell Assessment of Need rating scale, the Udvalg for Kliniske Undersøgelser side effect rating scale (SE), and the patient's previous treatment history (PT), was used to group the patients according to treatment response. CANSEPT was evaluated by comparison of expected and observed results. RESULTS: In the patient population (n = 123), the patients in functional remission, as defined by CANSEPT, had higher quality of life, fewer hospitalizations, fewer psychotic symptoms, and higher rate of workers than those with the worst treatment outcome. CONCLUSION: In the evaluation, CANSEPT showed validity in discriminating the patients of interest and was well tolerated by the patients. CANSEPT could secure inclusion of correct patients in the clinic or in research.

KW - Former Faculty of Pharmaceutical Sciences

U2 - 10.1016/j.comppsych.2008.11.001

DO - 10.1016/j.comppsych.2008.11.001

M3 - Journal article

C2 - 19683616

VL - 50

SP - 453

EP - 462

JO - Comprehensive Psychiatry

JF - Comprehensive Psychiatry

SN - 0010-440X

IS - 5

ER -