Clinical and Sociodemographic Associates of Remission from Positive Symptoms in Schizophrenia.

Abstract

Objectives: To determine factors associated with remission from positive symptoms in Indian patients with schizophrenia.

Methods: We evaluated 151 patients (99 men and 52 women) aged 18 to 65 years who were diagnosed with schizophrenia and followed up for ≥6 months (with a minimum of two evaluations). We assessed psychopathology, the level of best functioning in the past year, premorbid functioning (up to 1 year), daily living skills, medication adherence, adverse effects to medications, the number of stressful events in the 6 months before illness onset, perceived social support, expressed emotion from family, and personal construct of empowerment. Remission from positive symptoms of schizophrenia was defined as simultaneous attainment of a score of ≤3 (mild) for ≥6 months in the following symptoms: delusions, concept disorganisation, hallucinatory behaviour, unusual thought content, mannerisms, and posturing. Patients were categorised as remitted and non-remitted.

Results: Of 151 patients, 81 (53.64%) fulfilled the remission criteria. Compared with non-remitted patients, remitted patients had a shorter duration of untreated psychosis (t = -2.29, p < 0.05), better premorbid functioning in childhood (t = -1.99, p < 0.05) and general (t = -9.34, p < 0.001) subscale, higher medication adherence (t = 6.91, p < 0.001), higher daily living skills ( t = 8.65, p < 0.001), better perceived social support (t = 6.69, p < 0.001), higher empowerment (t = 5.64, p < 0.001), and received higher warmth (t = 1.99, p < 0.05) and lower hostility (t = -4.00, p < 0.001), dissatisfaction (t = -6.96, p < 0.001), and critical comments (t = -2.48, p < 0.05) from family members. Predictors of remission were duration of untreated psychosis (B = -0.020, p < 0.05), daily living skills (B = 2.063, p < 0.001), perceived social support (B = 0.084, p < 0.01), and dissatisfaction from family members (B = -0.621, p < 0.01).

Conclusions: 53.64% of patients with schizophrenia achieved remission from positive symptoms. Remission was more likely to occur in patients with shorter duration of untreated psychosis, better daily living skills, higher perceived social support, and less dissatisfaction from family members.