Definitions of response and remission in schizophrenia: recommendations for their use and their presentation

Abstract

Objective: To review and make recommendations for the definition and presentation of the terms 'response' and 'remission' in schizophrenia.

Method: Selective review of publications on definitions of response and remission in schizophrenia.

Results: When the Brief Psychiatric Rating Scale (BPRS) or the Positive and Negative Syndrome Scale (PANSS) are used for definitions of response, a cut-off of at least 50% reduction of the baseline score should be used for acutely ill, non-refractory patients and a cut-off of at least 25% reduction for refractory patients. When percentage BPRS/PANSS reduction is calculated, the 18/30 points minimum scores meaning 'no symptoms' on the should be subtracted. In addition, responder rates from 0-100% could be presented in a table in steps of 25%. For large and simple practical trials, the Clinical Global Impression scale with suggested improvements could be used 1-7 scale.

Conclusion: To show how many patients are still symptomatic at the end of study and to show the overall amount of change in both remission and responder criteria should be presented.