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Characteristics of Subjects With Schizophrenia Spectrum Disorder With and Without Antipsychotic Medication – a 10-Year Follow-Up of the Northern Finland 1966 Birth Cohort Study

Published online by Cambridge University Press:  14 September 2011

J. Moilanen ,
M. Haapea ,
J. Miettunen ,
E. Jääskeläinen ,
J. Veijola ,
M. Isohanni  and
H. Koponen
J. Moilanen*
Affiliation:
Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, P.O. BOX 5000, 90014Oulu, Finland
M. Haapea
Affiliation:
Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, P.O. BOX 5000, 90014Oulu, Finland Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland Institute of Biomedicine, Department of Physiology, University of Oulu, Oulu, Finland
J. Miettunen
Affiliation:
Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, P.O. BOX 5000, 90014Oulu, Finland Institute of Health Sciences, University of Oulu, Oulu, Finland
E. Jääskeläinen
Affiliation:
Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, P.O. BOX 5000, 90014Oulu, Finland
J. Veijola
Affiliation:
Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, P.O. BOX 5000, 90014Oulu, Finland
M. Isohanni
Affiliation:
Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, P.O. BOX 5000, 90014Oulu, Finland
H. Koponen
Affiliation:
University of Eastern Finland, Kuopio University Hospital, Department of Psychiatry, Kuopio, Finland
*
⁎Corresponding author. Tel.: +358 44 0690706; fax: +358 8 336169. E-mail address: [email protected] (J. Moilanen).
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Abstract

Objective

To estimate the prevalence of non-medicated subjects having schizophrenia spectrum disorder and to study how they differ from medicated subjects in terms of sociodemographic and illness-related variables. We also aim to find the predictors for successful antipsychotic withdrawal.

Methods

Data of 70 subjects with schizophrenic psychoses (mean duration of illness 10.4 years) from the Northern Finland 1966 Birth Cohort were gathered by interview at the age of 34 and from hospital records. The stability of remission was assessed by comparing hospitalization rates between non-medicated and medicated subjects over an 8.7-year additional follow-up period.

Results

Twenty-four (34%) subjects were currently not receiving medication. They were more often males, less often on a disability pension, more often in remission, and had better clinical outcomes. Relapses during the follow-up were equally frequent between non-medicated and medicated subjects (47% vs. 56%). Not having been hospitalised during previous 5 years before the interview predicted long-term successful antipsychotic withdrawal without relapse.

Conclusions

Despite a lack of precise predictors, there might be subgroup of schizophrenia spectrum subjects who do not need permanent antipsychotic medication, and a fewer previous psychiatric treatments may indicate such a subgroup.

Keywords

AntipsychoticsMedicatedNon-medicatedRemissionSchizophrenia
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 1 , January 2013 , pp. 53 - 58
Copyright
Copyright © European Psychiatric Association 2013

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Footnotes

1

Tel.: +358 8 3152480; fax: +358 8 3152112.

2

Tel.: +358 8 3156923; fax: +358 8 336169.

3

Tel.: +358 40 7474376; fax: +358 8 336169.

4

Tel.: +358 40 5237413; fax: +358 8 336169.

5

Tel.: +358 8 3156911; fax: +358 8 336169.

6

Tel.: +358 40 5505996; fax: +358 17 173549.

References

Almerie, M.Matar, H.Essali, A.Alkhateeb, H.Rezk, E.Cessation of medication for people with schizophrenia already stable on chlorpromazine. Schizophr Bull. 2008;34:13–14.CrossRefGoogle ScholarPubMed
Andreasen, N.C.Carpenter, W.T.Kane, J.M.Lasser, R.A.Marder, S.R.Weinberger, D.R.Remission in schizophrenia: Proposed criteria and rationale for consensus. Am J Psychiatry. 2005;162:441–449.CrossRefGoogle ScholarPubMed
Brissos, S.Dias, V.V.Balanzá-Martinez, V.Carita, A.I.Figueira, M.L.Symptomatic remission in schizophrenia patients: Relationship with social functioning, quality of life, and neurocognitive performance. Schizophr Res 2011. http://dx.doi.org/10.1016/j.schres.2011.04.001.CrossRefGoogle ScholarPubMed
Fenton, W.S.McGlashan, T.H.Sustained remission in drug-free schizophrenic patients. Am J Psych 1987;144:1306–1309.Google ScholarPubMed
Gilbert, P.Harris, M.McAdams, L.Jeste, D.Neuroleptic withdrawal in schizophrenic patients. A review of the literature. Arch Gen Psychiatry. 1995;52:173–188.CrossRefGoogle ScholarPubMed
Guy, W.EDCEU Assessment Manual for Psychopharmacology – Revised (DHEW Pupl No. ADM 76 338). Rockville, MD, U.S. Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs; 1976, p. 534–7.Google Scholar
Haapea, M.Miettunen, J.Veijola, J.Lauronen, E.Tanskanen, P.Isohanni, M.Non-participation may bias the results of a psychiatric survey: an analysis from the survey including magnetic resonance imaging within the Northern Finland 1966 Birth Cohort. Soc Psychiatry Psychiatric Epidemiol. 2007;42:403–409.CrossRefGoogle ScholarPubMed
Harrison, G.Hopper, K.Craig, T.Laska, E.Siegel, C.Wanderling, J.Recovery from psychotic illness: a 15- and 25-year international follow-up study. Br J Psychiatry 2001;178:506–517.CrossRefGoogle ScholarPubMed
Harrow, M.Jobe, T.H.Factors Involved in Outcome and Recovery in Schizophrenia Patients Not on Antipsychotic Medications: A 15-year multi-follow-up Study. J Nerv Ment Dis 2007;195:406–414.Google ScholarPubMed
Hopper, KHarrison, GWanderling, JA.An overview of course and outcome in ISoS, in recovery from schizophrenia. An international perspective. In: Hopper, KHarrison, GJanca, ASartorius, N (Eds). Oxford University Press, 2007, p. 23–38.Google Scholar
Isohanni, M.Mäkikyrö, T.Moring, J.Räsänen, P.Hakko, H.Partanen, U.A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Soc Psychiatry Psychiatr Epidemiol. 1997;32:303–308.CrossRefGoogle Scholar
Kane, J.M.Treatment strategies to prevent relapse and encourage remission. J Clin Psychiatry. 2007;68:27–30.Google ScholarPubMed
Karow, A.Moritz, S.Lambert, M.Schöttle, D.Naber, D.on behalf of the EGOFORS initiative. Remitted but still impaired? Symptomatic versus functional remission in patients with schizophrenia. Eur Psychiatry 2011 http://dx.doi.org/10.1016/j.eurpsy.2011.01.012.Google Scholar
Kay, S.R.Fiszbein, A.Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13:261–276.CrossRefGoogle Scholar
Leucht, S.Komossa, K.Rummel-Kluge, C.Hunger, H.Schmid, F.Asenjo Lobos, C.A meta-analysis of head-to-head comparisons of second-generation antipsychotics in the treatment of schizophrenia. Am J Psychiatry 2009;166:152–163.CrossRefGoogle ScholarPubMed
Maxwell, ME.Family Interview for Genetic Studies (FIGS): manual for the FIGS. Clinical Neurogenetics Branch. Intramural Research Program, National Institute of Mental Health, Bethesda, MD; 1992.Google Scholar
Moilanen, K.Veijola, J.Läksy, K.Mäkikyrö, T.Miettunen, J.Kantojärvi, L.Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort. Soc Psychiatry Psychiatric Epidemiol. 2003;38:305–310.CrossRefGoogle ScholarPubMed
Müller, N.Mechanism of relapse prevention in schizophrenia. Pharmacopsychiatry. 2004;37:141–147.CrossRefGoogle Scholar
Nishikawa, T.Hayashi, T.Koga, I.Uchida, Y.Neuroleptic withdrawal with remitted schizophrenics: a naturalistic follow-up study. Psychiatry. 2007;70:68–79.CrossRefGoogle ScholarPubMed
Perälä, J.Suvisaari, J.Saarni, S.I.Kuoppasalmi, K.Isometsä, E.Pirkola, S.Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry 2007;64:19–28.CrossRefGoogle Scholar
Rantakallio, P.Groups at risk in low birth weight infants and perinatal mortality. Acta Paediatr Scand. 1969;193:1–71.Google ScholarPubMed
Spitzer, R.L.Gibbon, M.Endicott, J.Global Assessment Scale (GAS), Global Assesment of Functioning (GAF) scale, Social and Occupational Functional Assesment Scale (SOFAS). American Psychiatric Association. Handbook of Psychiatric Measures. Washington: American Psychiatric Association; 2000.Google Scholar
Wunderink, L.Nienhuis, F.J.Sytema, F.Slooff, C.J.Knegtering, R.Wiersma, D.Guided discontinuation versus maintenance treatment in remitted first-episode psychosis: Relapse rates and functional outcome. J Clin Psychiatry 2007;68:5.CrossRefGoogle ScholarPubMed
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