What happens with schizophrenia patients after their discharge from hospital? Results on outcome and treatment from a “real-world” 2-year follow-up trial [2019]

Aim of the study was to examine the course of schizophrenia patients within 2 years after discharge. Within a multicenter study of the German Competence Network on Schizophrenia, patients suffering from a schizophrenia spectrum disorder were examined regarding their psychopathological improvement, tolerability, and the treatment regime applied during hospitalization and a 2-year follow-up period. Response, remission, the level of everyday functioning, and relapse were furthermore evaluated during the follow-up period using established definitions for these outcome domains. The psychopharmacological treatment was specifically evaluated in terms of a potential association with relapse. 149 patients were available for analysis, with 65% of the patients being in response, 52% in symptomatic remission, and 64% having a satisfiable everyday functioning 2 years after their discharge from hospital. Despite these favorable outcome rates, 63% of the patients suffered from a relapse within the 2-year follow-up period with 86% of these patients being rehospitalized. Discharge non-responder and non-remitter were twice as likely to relapse during follow-up. A significant decrease of side-effects was observed with negligible rates of extrapyramidal side-effects, sedation, and weight gain during follow-up. Patients receiving treatment with atypical antipsychotics were found to have the lowest risk to relapse (p < 0.0001). The results highlight the natural and unsteady course of schizophrenia in most patients underlining the need to develop more specific treatment strategies ensuring ongoing stability and preventing relapse.

Rebecca Schennach, Michael Riedel, Michael Obermeier, Markus Jäger, Max Schmauss, Gerd Laux, Herbert Pfeiffer, Dieter Naber, Lutz G. Schmidt, Wolfgang Gaebel, Joachim Klosterkötter, Isabella Heuser, Wolfgang Maier, Matthias R. Lemke, Eckart Rüther, Stefan Klingberg, Markus Gastpar, Florian Seemüller, Ilja Spellmann, Richard Musil & Hans-Jürgen Möller
European Archives of Psychiatry and Clinical Neuroscience, volume 270, (2020)