Better understanding of functional outcome predictors in schizophrenia has become key in order to face new challenges of the disease. The ESPASS survey aimed at evaluating the impact of antipsychotic therapy initiation or switch on psychosocial functioning in a sample of schizophrenic patients.

The primary objective was to evaluate the change from baseline to 6 months in EAS total score (psychosocial functioning scale). Other criteria were the change in the IAQ total score, CGI-S, and PASAP (satisfaction with care)

5962 were included by 1169 investigators. Mean age was 37±12, 62% were male, 72% single, 62% were outpatients, 34% of the patients were on therapy for 10 years or more, 47% had paranoid schizophrenia subtype. Prior to baseline, 23% had no antipsychotic therapy, 25% had a conventional and 52% had an atypical antipsychotic. 8% of the total sample were naïve to antipsychotic therapy.

Obesity mostly affected patients treated with atypicals in comparison to conventional antipsychotics (20% vs. 15%). The EAS total score was 46±20 with lower sub-scores in following domains: money earning, management of belongings, social and private relationships. Mean CGI-S score was 4.7±1.0 and IAQ total score was 22±4. 26% of the patients participated in a psychosocial rehabilitation program for 3 to 4 years.

While improving social functioning has clearly become key in the treatment of schizophrenia, only 26% of the patients were involved in an adequate rehabilitation program and 25% had a conventional antipsychotic.