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Decrease of Functioning in Remitted and Non-Remitted Patients 16 Years After a First-Episode Schizophrenia

Marchesi, Carlo MD*; Affaticati, Andrea MD; Monici, Alberto MD; De Panfilis, Chiara MD*; Ossola, Paolo MD*; Ottoni, Rebecca MD*; Tonna, Matteo MD

The Journal of Nervous and Mental Disease: June 2015 - Volume 203 - Issue 6 - p 406–411
doi: 10.1097/NMD.0000000000000299
Original Articles

In schizophrenia, a better level of functioning has been generally associated with symptomatic remission. However, this association has been supported by cross-sectional studies or by studies with a short follow-up period. Forty-eight patients with schizophrenia were evaluated by the Positive and Negative Symptoms Scale and the Social and Occupational Functioning Assessment Scale (SOFAS) at the first episode and after a mean period of 16 years. At follow-up, patients were defined as remitters (R) or non-remitters (NR) according to the Remission Schizophrenia Working Group criteria. R (n = 18; 37.5%) compared to NR showed at the first episode a lower illness severity and a better level of functioning. A functional decline was found in both groups at follow-up, even though NR showed a more than twofold reduction than R. Better SOFAS scores at follow-up were predicted by baseline SOFAS score and less severe negative symptoms at follow-up. Schizophrenia implies a functional decline over time, regardless of the symptomatic remission status with negative symptoms playing a major role.

*Department of Neuroscience, Psychiatry Unit, University of Parma; and †Mental Health Department, Local Health Agency, Parma, Italy.

Send reprint requests to Matteo Tonna, MD, Department of Neuroscience, Psychiatry Unit, University of Parma, Ospedale Maggiore, Padiglione Braga, Viale A. Gramsci 14, 43126 Parma, Italy. E-mail:

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