Studies of subjective wellbeing (SW) in schizophrenia have missed to define and to assess rate and predictors of SW response (SW-res) and SW remission (SW-rem). METHOD: A total of 727 patients with schizophrenia and severely impaired SW at entry (Subjective Wellbeing under Neuroleptics Scale, short version, SWN-K, total score <or =60) were treated with amisulpride over 12 weeks. SW-res was defined as SWN total score increase of at least 20% and by at least 10 points and SW-rem as total score of > or =80 points. RESULTS: Seventy percent fulfilled the SW-res criterion at week 4. At week 4 and week 12 (endpoint), the SW response criterion distinguished between patients with or without later SW remission and overall symptomatic and functional response. While 39% fulfilled the SW-rem criterion at endpoint, only 9.1% without early SW-res were in SW-rem at follow-up. Regression analyses indicated that SW-res was mainly predicted by greater severity of positive symptoms at baseline and SW-rem by lower severity of negative symptoms and better social functioning, and particularly by early SW-res. CONCLUSION: Patients with a risk of SW non-remission need to be identified early with subsequent treatment adaptation according to recommendations for incomplete remission and treatment resistance in schizophrenia.
