PortalPublikationenEarly Improvement As a Predictor of Later Response to Antips...

Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review

Standard

Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review. / Samara, Myrto T; Leucht, Claudia; Leeflang, Mariska M; Anghelescu, Ion-George; Chung, Young-Chul; Crespo-Facorro, Benedicto; Elkis, Helio; Hatta, Kotaro; Giegling, Ina; Kane, John M; Kayo, Monica; Lambert, Martin; Lin, Ching-Hua; Möller, Hans-Jürgen; Pelayo-Terán, José María; Riedel, Michael; Rujescu, Dan; Schimmelmann, Benno G; Serretti, Alessandro; Correll, Christoph U; Leucht, Stefan.

in: AM J PSYCHIAT, Jahrgang 172, Nr. 7, 07.2015, S. 617-29.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Samara, MT, Leucht, C, Leeflang, MM, Anghelescu, I-G, Chung, Y-C, Crespo-Facorro, B, Elkis, H, Hatta, K, Giegling, I, Kane, JM, Kayo, M, Lambert, M, Lin, C-H, Möller, H-J, Pelayo-Terán, JM, Riedel, M, Rujescu, D, Schimmelmann, BG, Serretti, A, Correll, CU & Leucht, S 2015, 'Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review', AM J PSYCHIAT, Jg. 172, Nr. 7, S. 617-29.

APA

Samara, M. T., Leucht, C., Leeflang, M. M., Anghelescu, I-G., Chung, Y-C., Crespo-Facorro, B., Elkis, H., Hatta, K., Giegling, I., Kane, J. M., Kayo, M., Lambert, M., Lin, C-H., Möller, H-J., Pelayo-Terán, J. M., Riedel, M., Rujescu, D., Schimmelmann, B. G., Serretti, A., ... Leucht, S. (2015). Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review. AM J PSYCHIAT, 172(7), 617-29.

Vancouver

Samara MT, Leucht C, Leeflang MM, Anghelescu I-G, Chung Y-C, Crespo-Facorro B et al. Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review. AM J PSYCHIAT. 2015 Jul;172(7):617-29.

Bibtex

@article{a00923dd67e24a4da624938fca3f9071,
title = "Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review",
abstract = "OBJECTIVE: How long clinicians should wait before considering an antipsychotic ineffective and changing treatment in schizophrenia is an unresolved clinical question. Guidelines differ substantially in this regard. The authors conducted a diagnostic test meta-analysis using mostly individual patient data to assess whether lack of improvement at week 2 predicts later nonresponse.METHOD: The search included EMBASE, MEDLINE, BIOSIS, PsycINFO, Cochrane Library, CINAHL, and reference lists of relevant articles, supplemented by requests to authors of all relevant studies. The main outcome was prediction of nonresponse, defined as <50% reduction in total score on either the Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS) (corresponding to at least much improved) from baseline to endpoint (4-12 weeks), by <20% PANSS or BPRS improvement (corresponding to less than minimally improved) at week 2. Secondary outcomes were absent cross-sectional symptomatic remission and <20% PANSS or BPRS reduction at endpoint. Potential moderator variables were examined by meta-regression.RESULTS: In 34 studies (N=9,460) a <20% PANSS or BPRS reduction at week 2 predicted nonresponse at endpoint with a specificity of 86% and a positive predictive value (PPV) of 90%. Using data for observed cases (specificity=86%, PPV=85%) or lack of remission (specificity=77%, PPV=88%) yielded similar results. Conversely, using the definition of <20% reduction at endpoint yielded worse results (specificity=70%, PPV=55%). The test specificity was significantly moderated by a trial duration of <6 weeks, higher baseline illness severity, and shorter illness duration.CONCLUSIONS: Patients not even minimally improved by week 2 of antipsychotic treatment are unlikely to respond later and may benefit from a treatment change.",
keywords = "Antipsychotic Agents, Drug Substitution, Humans, Prognosis, Psychiatric Status Rating Scales, Psychometrics, Schizophrenia, Schizophrenic Psychology",
author = "Samara, {Myrto T} and Claudia Leucht and Leeflang, {Mariska M} and Ion-George Anghelescu and Young-Chul Chung and Benedicto Crespo-Facorro and Helio Elkis and Kotaro Hatta and Ina Giegling and Kane, {John M} and Monica Kayo and Martin Lambert and Ching-Hua Lin and Hans-J{\"u}rgen M{\"o}ller and Pelayo-Ter{\'a}n, {Jos{\'e} Mar{\'i}a} and Michael Riedel and Dan Rujescu and Schimmelmann, {Benno G} and Alessandro Serretti and Correll, {Christoph U} and Stefan Leucht",
year = "2015",
month = jul,
language = "English",
volume = "172",
pages = "617--29",
journal = "AM J PSYCHIAT",
issn = "0002-953X",
publisher = "American Psychiatric Association",
number = "7",

}

RIS

TY - JOUR

T1 - Early Improvement As a Predictor of Later Response to Antipsychotics in Schizophrenia: A Diagnostic Test Review

AU - Samara, Myrto T

AU - Leucht, Claudia

AU - Leeflang, Mariska M

AU - Anghelescu, Ion-George

AU - Chung, Young-Chul

AU - Crespo-Facorro, Benedicto

AU - Elkis, Helio

AU - Hatta, Kotaro

AU - Giegling, Ina

AU - Kane, John M

AU - Kayo, Monica

AU - Lambert, Martin

AU - Lin, Ching-Hua

AU - Möller, Hans-Jürgen

AU - Pelayo-Terán, José María

AU - Riedel, Michael

AU - Rujescu, Dan

AU - Schimmelmann, Benno G

AU - Serretti, Alessandro

AU - Correll, Christoph U

AU - Leucht, Stefan

PY - 2015/7

Y1 - 2015/7

N2 - OBJECTIVE: How long clinicians should wait before considering an antipsychotic ineffective and changing treatment in schizophrenia is an unresolved clinical question. Guidelines differ substantially in this regard. The authors conducted a diagnostic test meta-analysis using mostly individual patient data to assess whether lack of improvement at week 2 predicts later nonresponse.METHOD: The search included EMBASE, MEDLINE, BIOSIS, PsycINFO, Cochrane Library, CINAHL, and reference lists of relevant articles, supplemented by requests to authors of all relevant studies. The main outcome was prediction of nonresponse, defined as <50% reduction in total score on either the Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS) (corresponding to at least much improved) from baseline to endpoint (4-12 weeks), by <20% PANSS or BPRS improvement (corresponding to less than minimally improved) at week 2. Secondary outcomes were absent cross-sectional symptomatic remission and <20% PANSS or BPRS reduction at endpoint. Potential moderator variables were examined by meta-regression.RESULTS: In 34 studies (N=9,460) a <20% PANSS or BPRS reduction at week 2 predicted nonresponse at endpoint with a specificity of 86% and a positive predictive value (PPV) of 90%. Using data for observed cases (specificity=86%, PPV=85%) or lack of remission (specificity=77%, PPV=88%) yielded similar results. Conversely, using the definition of <20% reduction at endpoint yielded worse results (specificity=70%, PPV=55%). The test specificity was significantly moderated by a trial duration of <6 weeks, higher baseline illness severity, and shorter illness duration.CONCLUSIONS: Patients not even minimally improved by week 2 of antipsychotic treatment are unlikely to respond later and may benefit from a treatment change.

AB - OBJECTIVE: How long clinicians should wait before considering an antipsychotic ineffective and changing treatment in schizophrenia is an unresolved clinical question. Guidelines differ substantially in this regard. The authors conducted a diagnostic test meta-analysis using mostly individual patient data to assess whether lack of improvement at week 2 predicts later nonresponse.METHOD: The search included EMBASE, MEDLINE, BIOSIS, PsycINFO, Cochrane Library, CINAHL, and reference lists of relevant articles, supplemented by requests to authors of all relevant studies. The main outcome was prediction of nonresponse, defined as <50% reduction in total score on either the Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS) (corresponding to at least much improved) from baseline to endpoint (4-12 weeks), by <20% PANSS or BPRS improvement (corresponding to less than minimally improved) at week 2. Secondary outcomes were absent cross-sectional symptomatic remission and <20% PANSS or BPRS reduction at endpoint. Potential moderator variables were examined by meta-regression.RESULTS: In 34 studies (N=9,460) a <20% PANSS or BPRS reduction at week 2 predicted nonresponse at endpoint with a specificity of 86% and a positive predictive value (PPV) of 90%. Using data for observed cases (specificity=86%, PPV=85%) or lack of remission (specificity=77%, PPV=88%) yielded similar results. Conversely, using the definition of <20% reduction at endpoint yielded worse results (specificity=70%, PPV=55%). The test specificity was significantly moderated by a trial duration of <6 weeks, higher baseline illness severity, and shorter illness duration.CONCLUSIONS: Patients not even minimally improved by week 2 of antipsychotic treatment are unlikely to respond later and may benefit from a treatment change.

KW - Antipsychotic Agents

KW - Drug Substitution

KW - Humans

KW - Prognosis

KW - Psychiatric Status Rating Scales

KW - Psychometrics

KW - Schizophrenia

KW - Schizophrenic Psychology

M3 - SCORING: Journal article

C2 - 26046338

VL - 172

SP - 617

EP - 629

JO - AM J PSYCHIAT

JF - AM J PSYCHIAT

SN - 0002-953X

IS - 7

ER -