Interrelationships of Changes in Outcome Domains in Patients With Schizophrenia Spectrum Disorders: A Meta-Analysis

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2025-03-30 DOI:10.1111/acps.13808

Lars de Winter, Auke Jelsma, Jentien M. Vermeulen, Astrid Vellinga, Jaap van Weeghel, Ilanit Hasson-Ohayon, Cornelis L. Mulder, Nynke Boonstra, Wim Veling, Lieuwe de Haan

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引用次数: 0

Abstract

Introduction

Patients with schizophrenia spectrum disorders (SSD) improve in several outcome domains over the course of illness, but to different degrees. In this meta-analysis, we investigated whether longitudinal changes in different outcome domains are associated with each other and which factors moderate these changes over time.

Methods

Our protocol was preregistered in PROSPERO (CRD42024504253). We included 109 studies, identified through searches in PsycInfo, PubMed, CINAHL, and Cochrane up until November 2023, investigating longitudinal changes in at least two outcome domains (symptoms, social functioning, cognition or personal recovery) for patients with SSD with at least 1 year follow-up. We calculated Pearson correlation coefficients for associations of changes between outcome domains. Potential moderating effects of demographic, clinical, social, or study characteristics were explored. Quality assessment was executed using the QUIPS tool.

Results

We found substantial positive associations between changes in symptoms, social functioning, and cognition. Especially, changes in negative symptoms and overall social functioning were associated with changes in several outcome domains. Changes in personal recovery were only associated with changes in symptoms. We found more substantial improvements in combinations of outcomes for patients with a shorter illness duration, females, a lower percentage of patients diagnosed with schizophrenia, and patients receiving treatment focused on targeted outcomes.

Conclusions

Symptoms, social functioning, and cognition often concurrently improve and may boost each other. This suggests that an integrated approach targeting several outcome domains jointly boosts long-term improvement. However, changes in personal recovery seem to occur separately from other outcome domains. Therefore, targeted attention for personal recovery is needed.

Trial Registration: PROSPERO: CRD42024504253

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精神分裂症谱系障碍患者预后域变化的相互关系：一项荟萃分析

简介：精神分裂症谱系障碍（SSD）患者在疾病过程中在几个结果领域有所改善，但程度不同。在这项荟萃分析中，我们调查了不同结果域的纵向变化是否相互关联，以及哪些因素随着时间的推移缓和了这些变化。方法：我们的方案在PROSPERO （CRD42024504253）中预注册。我们纳入了109项研究，通过PsycInfo、PubMed、CINAHL和Cochrane的搜索确定，直到2023年11月，研究了至少1年随访的SSD患者至少两个结果领域（症状、社会功能、认知或个人恢复）的纵向变化。我们计算了结果域之间变化关联的Pearson相关系数。探讨了人口统计学、临床、社会或研究特征的潜在调节作用。使用QUIPS工具进行质量评估。结果：我们发现症状变化、社会功能和认知之间存在显著的正相关。特别是，负面症状和整体社会功能的变化与几个结果域的变化有关。个人恢复的变化仅与症状的变化有关。我们发现病程较短的患者、女性患者、诊断为精神分裂症的患者比例较低的患者以及接受靶向治疗的患者的综合结果有更大的改善。结论：症状、社会功能和认知往往同时改善，并可能相互促进。这表明，针对几个结果领域的综合方法可以共同促进长期改善。然而，个人康复的变化似乎与其他结果领域是分开发生的。因此，需要有针对性地关注个人康复。试验注册：PROSPERO: CRD42024504253。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.