sustained favorable long-term outcome in the treatment of schizophrenia a 3-year prospective observational study持续良好的长期结果治疗精神分裂症的一个三年的前瞻性研究.pdf

Cuyún Carter et al. BMC Psychiatry 2011, 11:143 /1471-244X/11/143 RESEARCH ARTICLE Open Access Sustained favorable long-term outcome in the treatment of schizophrenia: a 3-year prospective observational study * Gebra B Cuyún Carter , Denái R Milton, Haya Ascher-Svanum and Douglas E Faries Abstract Background: This study of chronically ill patients with schizophrenia aimed to identify patients who achieve sustained favorable long-term outcome - when the outcome incorporates severity of symptoms, level of functioning, and use of acute care services - and to identify the best baseline predictors of achieving this sustained favorable long-term outcome. Methods: Using data from the United States Schizophrenia Care and Assessment Program (US-SCAP) (N = 2327), a large 3-year prospective, multisite, observational study of individuals treated for schizophrenia in the US, a hierarchical cluster analysis was performed to group patients based upon baseline symptom severity. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS) scores, level of functioning, and use of acute care services. Level of functioning reflected patient-reported productivity and clinician-rated occupational role functioning. Use of acute care services reflected self-reported psychiatric hospitalization and emergency service use. Change of health state was determined over the 3-year period. A patient was classified as having a sustained favorable long-term outcome if their health state values had the closest distance to the defined “best baseline cluster” at each point over the length of the study. Stepwise logistic regression was used to determine baseline predictors of sustained favorable long-term outcome. Results: At baseline, 5 distinct health state clusters were identified, ranging from “