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An early improvement in depressive symptoms predicts symptomatic remission of schizophrenia treated with quetiapine: a multicenter, 4-week case–control study

Chou, Yuan-Hwaa,b; Chiu, Nien-Muf,g; Yang, Tsung-Tsairc; Feng, Jungd; Chan, Chia-Chene; Lee, Howard-KanthOSCAR-S Study Group

International Clinical Psychopharmacology: September 2013 - Volume 28 - Issue 5 - p 255–260
doi: 10.1097/YIC.0b013e328363aa33
Original Articles

The aim of this study was to determine whether an early improvement in depressive symptoms is a predictor of symptomatic remission in schizophrenia. Patients with DSM-IV schizophrenia diagnosis who received antipsychotic treatment but did not fulfill Andreasen’s symptomatic remission criteria were recruited. Each patient received quetiapine with a flexible dose strategy of 300–800 mg daily for 4 weeks after a 1-week washout period of previous antipsychotics. Remission was defined by Andreasen’s criteria, which includes eight items of the Positive and Negative Symptom Scale with scores of less than three in each item. Seventy-five patients completed the study. Of these, 27 (36%) achieved symptomatic remission after treatment with quetiapine. A significant improvement in depressive symptoms was found in both the remission and the nonremission groups, although the improvement was less pronounced in the nonremission group at the endpoint. Binary logistic regression analysis showed that age (β=−0.07, P=0.02) and early improvement in depressive symptoms within the first 3 days were predictive of symptomatic remission (β=−0.27, P=0.01) for the treatment of schizophrenia. Our data suggest that an early improvement in depressive symptoms in the treatment of schizophrenia is crucial for symptomatic remission.

aDepartment of Psychiatry, Taipei Veteran General Hospital

bDepartment of Psychiatry, National Yang Ming University

cNational Defense Medical Center

dDepartment of Psychiatry, Far Eastern Memorial Hospital

eDepartment of Psychiatry, Taipei City Hospital Zhongxing Branch, Taipei

fDepartments of Psychiatry, Kaohsiung Chang Gung Memorial Hospital

gDepartment of Psychiatry, Chang Gung University College of Medicine, Kaohsiung

hDepartment of Psychiatry, Tung Taichung MetroHarbor Hospital, Taichung, Taiwan

Correspondence to Yuan-Hwa Chou, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, No 201, Sec 2, Shin-Pai Road, Beitou, Taipei 112, Taiwan Tel: +886 2 28711290; fax: +886 2 28768403; e-mail:

Received March 19, 2013

Accepted May 28, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins