Pharmacopsychiatry 2004; 37: 126-135
DOI: 10.1055/s-2004-832666
Schizophrenia
© Georg Thieme Verlag KG Stuttgart · New York

Course and Long-Term Treatment of Schizophrenic Psychoses

H.-J. Möller1
  • 1Psychiatrische Klinik der Ludwig-Maximilians-Universität, München, Germany
Further Information

Publication History

Publication Date:
16 November 2004 (online)

As there is a lack of clear biological correlates for most psychiatric disorders, follow-up studies regarding course, outcome and prognosis of psychiatric disorders play an important role in psychiatric research, especially in terms of validation of psychiatric diagnoses and other psychiatric concepts, such as the concept of negative symptoms. Long-term studies also have their place in the description and evaluation of first treatment procedures. The first part of this paper will describe some general aspects of the long-term course and outcome of schizophrenic psychoses. The problem of relapses and relapse prevention will then be discussed. Especially data from recent studies will be considered in this overview.

References

  • 1 Arato M, O’Connor R, Meltzer H. Zeus study group. Ziprasidone in the long-term treatment of negative symptoms and the prevention of exacerbation of schizophrenia.  Int Clin Psychopharmacol. 2002;  17 207-215
  • 2 Bäuml J, Kissling W, Meurer C, Wais A, Lauter H. Informationszentrierte Angehörigengruppe zur Complianceverbesserung bei schizophrenen Patienten.  Psychiatr Prax. 1991;  18 48-54
  • 3 Beasley C, Hamilton S, Dossenbach M. Relapse prevention with olanzapine.  Eur Neuropsychopharmacol. 2000;  10 S304
  • 4 Bleuler M. Dementia Praecox or the group of schizophrenias. New York; International University Press 1950
  • 5 Bottlender R, Jager M, Groll C, Strauss A, Moller H J. Deficit states in schizophrenia and their association with the length of illness and gender.  Eur Arch Psychiatry Clin Neurosci. 2001;  251 272-278
  • 6 Bottlender R, Sato T, Jager M, Wegener U, Wittmann J, Strauss A. et al . The impact of the duration of untreated psychosis prior to first psychiatric admission on the 15-year outcome in schizophrenia.  Schizophr Res. 2003;  62 37-44
  • 7 Bottlender R, Strauß A, Möller H J. Impact of duration of symptoms prior to first hospitalization on acute outcome in 998 schizophrenic patients.  Schizophrenia Research. 2000;  44 145-150
  • 8 Buchkremer G, Schulze-Mönking H, Holle R, Hornung W P. The impact of therapeutic relatives’ groups on the course of illness of schizophrenic patients.  Eur Psychiatry. 1995;  10 17-27
  • 9 Carpenter Jr W T, Heinrichs D W, Wagman A M. Deficit and nondeficit forms of schizophrenia: the concept.  Am J Psychiatry. 1988;  145 578-583
  • 10 Cheung H K. Schizophrenics fully remitted on neuroleptics for 3-5 years - to stop or continue drugs.  Br J Psychiat. 1981;  138 490-494
  • 11 Cooper S J, Butler A, Tweed J, Welch C, Raniwalla J. Zotepine in the prevention of recurrence: a randomised, double-blind, placebo-controlled study for chronic schizophrenia.  Psychopharmacology (Berl). 2000;  150 237-243
  • 12 Cramer J A, Rosenheck R. Compliance with medication regimens for mental and physical disorders.  Psychiatr Serv. 1998;  49 196-201
  • 13 Csernansky J G, Mahmoud R, Brenner R. A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia.  N Engl J Med. 2002;  346 16-22
  • 14 Daniel D G, Wozniak P, Mack R J, McCarthy B G. Long-term efficacy and safety comparison of sertindole and haloperidol in the treatment of schizophrenia. The Sertindole Study Group.  Psychopharmacol Bull. 1998;  34 61-69
  • 15 Davis J M, Matalon L, Watanabe M D, Blake L, Matalon L. Depot antipsychotic drugs. Place in therapy.  Drugs. 1994;  47 741-773
  • 16 Dellva M A, Tran P, Tollefson G D, Wentley A L, Beasley C -MJ. Standard olanzapine versus placebo and ineffective-dose olanzapine in the maintenance treatment of schizophrenia.  Psychiatr Serv. 1997;  48 1571-1577
  • 17 Essock S M, Hargreaves W A, Covell N H, Goethe J. Clozapine’s effectiveness for patients in state hospitals: results from a randomized trial.  Psychopharmacol Bull. 1996;  32 683-697
  • 18 Fenton W S. Course and outcome in schizophrenia.  Curr Opin Psychiatry. 1997;  10 40-44
  • 19 Gaebel W. Is intermittent, early intervention medication an alternative for neuroleptic maintenance treatment?.  Int Clin Psychopharmacol. 1995;  9 (Supl 5) 11-16
  • 20 Goldberg J F, Harrow M, Grossman L S. Course and outcome in bipolar affective disorder: a longitudinal follow-up study.  Am J Psychiatry. 1995;  152 379-384
  • 21 Goldberg S C, Schooler N R, Hogarty G E, Roper M. Prediction of relapse in schizophrenic outpatients treated by drug and sociotherapy.  Arch Gen Psychiatry. 1977;  34 171-184
  • 22 Grossman L S, Harrow M, Goldberg J F, Fichtner C G. Outcome of schizoaffective disorder at two long-term follow-ups: comparisons with outcome of schizophrenia and affective disorders.  Am J Psychiatry. 1991;  148 1359-1365
  • 23 Hirsch S R, Gaind R, Rohde P D, Stevens B C, Wing J K. Outpatient maintenance of chronic schizophrenic patients with long-acting fluphenazine: double-blind placebo trial. Report to the Medical Research Council Committee on Clinical Trials in Psychiatry.  Br Med J. 1973;  1 633-637
  • 24 Hogarty G E, Goldberg S, Schooler N, Ulrich R. Drug and sociotherapy in the aftercare of schizophrenic patients. II. Two-years relapse rates.  Arch Gen Psychiatry. 1974;  31 603-608
  • 25 Hogarty G E, Goldberg S C. Drug and sociotherapy in the aftercare of schizophrenic patients. One-year relapse rates.  Arch Gen Psychiatry. 1973;  28 54-64
  • 26 Jäger M, Bottlender R, Wegner U, Wittmann J, Strauss A, Möller H J. 15-Jahres-Katamnese schizophrener Psychosen im Vergleich zu affektiven und schizoaffektiven Psychosen. In: Möller HJ, Müller N, (eds) Schizophrenie: Langzeitverlauf und Langzeittherapie. Wien; Springer 2004: 23-30
  • 27 Jolley A G, Hirsch S R, Morrison E, McRink A, Wilson L. Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical and social outcome at two years.  BMJ. 1990;  301 837-842
  • 28 Kane J M, Aguglia E, Altamura A C, Ayuso-Gutierrez J L, Brunello N, Fleischhacker W W. et al . Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology Consensus Conference in Siena, Italy.  Eur Neuropsychopharmacol. 1998;  8 55-66
  • 29 Kraepelin E. Dementia Praecox. Edinburgh; E.S. Liningstone 1919
  • 30 Leff J P, Wing J K. Trial of maintenance therapy in schizophrenia.  Br Med J. 1971;  3 599-604
  • 31 Leucht S, Barnes T, Kissling W, Engel R, Kane J M. Relapse prevention in schizophrenia with new antipsychotics: a meta-analysis of randomized controlled trials.  Am J Psychiatry. 2003;  160 1209-1222
  • 32 Lieberman J A, Koreen A R, Chakos M, Sheitman B, Woerner M, Alvir J M. et al . Factors influencing treatment response and outcome of first-episode schizophrenia: implications for understanding the pathophysiology of schizophrenia.  J Clin Psychiatry. 1996;  57 Suppl 9 5-9
  • 33 Loo H, Poirier-Littre M F, Theron M, Rein W, Fleurot O. Amisulpride versus placebo in the medium-term treatment of the negative symptoms of schizophrenia.  Br J Psychiat. 1997;  170 18-22
  • 34 Marder S R, Glynn S M, Wirshing W C, Wirshing D A, Ross D, Widmark C. et al . Maintenance treatment of schizophrenia with risperidone or haloperidol: two years outcomes.  Am J Psychiatry. 2003;  160 1405-1412
  • 35 Marder S R, Van Putten T, Mintz J, Lebell M, McKenzie J, May P R. Low- and conventional-dose maintenance therapy with fluphenazine decanoate. Two-year outcome.  Arch Gen Psychiatry. 1987;  44 518-521
  • 36 Marneros A, Deister A, Rohde A. Affektive, schizoaffektive und schizophrene Psychosen. Eine vergleichende Langzeitstudie. [Affective, schizoaffective and schizophrenic psychoses. A comparative long-term study].  Monogr Gesamtgeb Psychiatr Psychiatry Ser. 1991;  65 1-454
  • 37 McGlashan T H. A selective review of recent North American long-term followup studies of schizophrenia.  Schizophr Bull. 1988;  14 515-542
  • 38 Meltzer H Y, Alphs L, Green A, Altamura A C, Anand R, Bertoli A. et al . Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT).  Arch Gen Psychiatry. 2003;  60 82-91
  • 39 Möller H J. Neuroleptische Langzeittherapie schizophrener Erkrankungen. In: Heinrich K, (ed) Leitlinien neuroleptischer Therapie. Berlin Heidelberg New York; Springer 1990: 97-115
  • 40 Möller H J. Zur Vorhersage des mittelfristigen Verlaufs schizophrener Psychosen. In: Heinrich K, Klieser E, Lehmann E, (eds) Prädiktoren des Therapieverlaufs endogener Psychosen. Stuttgart New York; Schattauer 1993: 85-105
  • 41 Möller H J. Definition, psychopharmacological basis and clinical evaluation of novel/atypical neuroleptics: methodological issues and clinical consequences.  World J Biol Psychiatry. 2000;  1 75-91
  • 42 Möller H J. State of the art of drug treatment of schizophrenia and the future position of the novel/atypical antipsychotics.  World J Biol Psychiatry. 2000;  1 204-214
  • 43 Möller H J. Antipsychotic agents - gradually improving treatment. Br J Psychiat 2003: In Press
  • 44 Möller H J. Depressive Comorbidität/Co-syndromibidität im Rahmen schizophrener Psychosen und ihre Therapie. In: Fleischhacker WW, Hummer N (eds) Schizophrene Störungen. State of the Art 3. Innsbruck; VIP Verlag, 2004: 175-202
  • 45 Möller H J. Der Einsatz neuer Antipsychotika in der Langzeittherapie der Schizophrenie. In: Möller HJ, Müller N, (eds) Schizophrenie. Langzeitverlauf und Langzeittherapie. Vienna New York; Springer 2004: 247-266
  • 46 Möller H J, Bottlender R, Groß A, Hoff P, Wittmann J, Wegner U. et al . The Kraepelinian dichotomy: preliminary results of a 15-year follow-up study on functional psychoses: focus on negative symptoms.  Schizophr Res. 2002;  56 87-94
  • 47 Möller H J, Bottlender R, Wegner U, Wittmann J, Strauß A. Long-term course of schizophrenic, affective and schizoaffective psychosis: focus on negative symptoms and their impact on global indicators of outcome.  Acta Psychiatr Scand. 2000;  102 (Suppl 407) 54-57
  • 48 Möller H J, Deister A. Schizophrenie. In: Möller HJ, Laux G, Kapfhammer H-P, (eds) Psychiatrie und Psychotherapie. Berlin Heidelberg New York; Springer 2000: 997-1068
  • 49 Möller H J, Gagiano C A, Addington D E, Von Knorring L, Torres-Plank J -F, Gaussares C. Long-term treatment of chronic schizophrenia with risperidone: an open-label, multicenter study of 386 patients.  Int Clin Psychopharmacol. 1998;  13 99-106
  • 50 Möller H J, Hohe-Schramm M, Cording-Tömmel C, Schmid Bode W, Wittchen H U, Zaudig M. et al . The classification of functional psychoses and its implications for prognosis.  Br J Psychiatry. 1989;  154 467-472
  • 51 Möller H J, Kissling W, Stoll K D, Wendt G. Psychopharmakotherapie. Ein Leitfaden für Klinik und Praxis. Stuttgart; Kohlhammer 1989
  • 52 Möller H J, Schmid Bode W, Cording-Tömmel C, Wittchen H U, Zaudig M, von Zerssen D. Psychopathological and social outcome in schizophrenia versus affective/schizoaffective psychoses and prediction of poor outcome in schizophrenia. Results from a 5 - 8 year follow-up.  Acta Psychiatr Scand. 1988;  77 379-389
  • 53 Möller H J, von Zerssen D. Der Verlauf schizophrener Psychosen unter den gegenwärtigen Behandlungsbedingungen. Berlin Heidelberg New York; Springer 1986
  • 54 Müller P. Die Patienten und das Ergebnis der Rezidivprophylaxe. In: Müller P, (ed) Zur Rezidivprophylaxe schizophrener Psychosen. Stuttgart; Enke 1982: 15-23
  • 55 Oehl M, Hummer M, Fleischhacker W W. Compliance with antipsychotic treatment.  Acta Psychiatr Scand Suppl. 2000;  102 83-86
  • 56 Rabinowitz J, Lichtenberg P, Kaplan Z, Mark M, Nahon D, Davidson M. Rehospitalization rates of chronically ill schizophrenic patients discharged on a regimen of risperidone, olanzapine, or conventional antipsychotics.  Am J Psychiatry. 2001;  158 266-269
  • 57 Riedel M, Strassnig M, Möller H J, Müller N. Die Stellung der Depot-Neuroleptika aus heutiger Sicht. In: Möller HJ, Müller N, (eds) Schizophrenia. Langzeitverlauf und Langzeittherapie. Vienna New York; Springer 2004: 215-231
  • 58 Rifkin A, Quitkin F, Rabiner C J, Klein D F. Fluphenazine decanoate, fluphenazine hydrochloride given orally, and placebo in remitted schizophrenics. I. Relapse rates after one year.  Arch Gen Psychiatry. 1977;  34 43-47
  • 59 Rosenheck R, Chang S, Choe Y, Cramer J, Xu W, Thomas J. et al . Medication continuation and compliance: a comparison of patients treated with clozapine and haloperidol.  J Clin Psychiatry. 2000;  61 382-386
  • 60 Rosenheck R, Evans D, Herz L, Cramer J, Xu W, Thomas J. et al . How long to wait for a response to clozapine: a comparison of time course of response to clozapine and conventional antipsychotic medication in refractory schizophrenia.  Schizophr Bull. 1999;  25 709-719
  • 61 Sheperd M. A Study of the Major Psychoses in an English Country. London; Chapman and Hall 1957
  • 62 Speller J C, Barnes T R, Curson D A, Pantelis C, Alberts J L. One-year, low-dose neuroleptic study of in-patients with chronic schizophrenia characterised by persistent negative symptoms. Amisulpride v. haloperidol.  Br J Psychiatry. 1997;  171 564-568
  • 63 Tamminga C A, Thaker G K, Moran M, Kakigi T, Gao X M. Clozapine in tardive dyskinesia: observations from human and animal model studies.  J Clin Psychiatry. 1994;  55 (Suppl B) 102-106
  • 64 Tran P V, Dellva M A, Tollefson G D, Wentley A L, Beasley C -M. Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses.  Br J Psychiatry. 1998;  172 499-505
  • 65 Tsuang M T, Woolson R F, Fleming J A. Long-term outcome of major psychoses. I. Schizophrenia and affective disorders compared with psychiatrically symptom-free surgical conditions.  Arch Gen Psychiatry. 1979;  36 1295-1301
  • 66 Volz H P, Kasper S, Möller H J, Sachs G, Höse A. Die Rolle der Kognition in der Therapie schizophrener Störungen. Wiesbaden; Deutscher Universitäts-Verlag 2003
  • 67 Watt D C, Katz K, Shepherd M. The natural history of schizophrenia: a 5-year prospective follow-up of a representative sample of schizophrenics by means of a standardized clinical and social assessment.  Psychol Med. 1983;  13 663-670

Prof. Dr. Hans-Jürgen Möller

Psychiatrische Klinik der Ludwig-Maximilians-Universität

Nußbaumstr. 7

80336 München

Phone: +89 5160 5501

Fax: +89 5160 5522

Email: hans-juergen.moeller@med.uni-muenchen.de

    >