SA60. Outcomes and Their Predictors in Schizophrenia: Systematic Reviews

Abstract

Background: The aim is to present key results of recent systematic reviews and meta-analyses on outcomes of schizophrenia. Methods: The included reviews focus on the proportion of recovery in schizophrenia and how outcomes are predicted by different factors, such as family history of psychosis, onset age, and duration of untreated psychosis (DUP). In each review, a comprehensive search strategy was used and data were extracted from original articles that met the preset inclusion criteria. Recovery was defned as improvements in both clinical and social domains with a 2-year good outcome for at least one of the domains. In all studies, a follow-up of at least 2 years was required. Results: The median proportion of recovery was 13.5%. Countries with poorer economic status had higher recovery proportions. Proportion of recovered cases had not increased in the recent decades. DUP associated with poor general symptomatic outcome, more severe positive and negative symptoms, lower likelihood of remission, poor social functioning, and poor global outcome (correlations 0.13-0.18). In turn, longer DUP was not associated with employment, quality of life, or hospital treatment. Family history of psychosis was associated with poor occupational (r =.17) and global (r =.13) outcome. Earlier onset age associated with more hospital-izations, negative symptoms, relapses, worse social/occupational functioning, and poorer global outcome (correlations.11-.17). Conclusion: The prognosis of schizophrenia is of great scientifc and public health importance. Approximately 1 in 7 individuals with schizophrenia met criteria for recovery. Despite major changes in treatment options in recent decades, the proportion of recovered cases has not increased. It is possible that schizophrenia patients are not treated effciently or effcient treatments are not available for all patients. Family history of psychosis, earlier onset age, and longer duration of untreated psychosis associated moderately with poorer long-term outcomes in schizophrenia. Current outcomes are unsatisfactory and their exact mechanisms, trajectories, and predictors are partly unknown.