Mean reductions in PANSS total score at week 24 were significantly lower in those fulfilling RSWG criteria (-21.7 vs -42.6 in those fulfilling Lieberman criteria). Further, improvements of quality of life (QLS total score) were significantly lower with RSWG criteria (+15.4 vs +19.6 with Lieberman criteria). Regression analysis assessed the
relative contribution of each of the components of the two ROCK inhibitor remission criteria (severity thresholds) to improvements in QLS total score. BPRS change scores accounted for the greatest effect on QLS total score improvements. The authors concluded that the Lieberman criteria appeared more stringent than the RSWG criteria, as almost all patients achieving the Lieberman criteria Inhibitors,research,lifescience,medical also achieved the RSWG criteria, while the converse was not apparent. In 2006, van Os and colleagues9 Inhibitors,research,lifescience,medical assessed whether a change in remission status would be associated with changes in clinician-reported and patient-reported functional outcomes. A total of 317 patients with a median follow-up of 3.1 years were separated into patients with (n=145, 46%) or without (n=172, 54%) remission at baseline. These groups were followed up for change in remission status over time, and those who had
changed were compared with nonchanged Inhibitors,research,lifescience,medical individuals for improvement in functional and quality of life outcomes. Within this study, the RSWG criteria were compared with RSWG criteria including the two PANSS items “depression” and “suicidality.” Of the 145 patients, 35% moved out of remission and 31% moved into remission. When including depression and suicidality into the remission criteria these frequencies Inhibitors,research,lifescience,medical did not change considerably (37% and 29%). In both groups, change in remission status was associated with large differences in functional outcomes measured
with the GAF and, to a lesser extent, in quality of life. This led the authors to conclude that the proposed remission criteria have “clinical validity.” In 2007, Leucht and colleagues reanalyzed 7 antipsychotic trials (n=1708) of patients with schizophrenia comparing Inhibitors,research,lifescience,medical three sets of remission criteria10: (i) the RSWG criteria; (ii) the Lieberman criteria; and (iii) the criteria Cell press by Liberman et al.11 The latter require that the 9 BPRS items grandiosity, suspiciousness, unusual thought content, hallucinations, conceptual disorganization, bizarre behavior, self-neglect, blunted affect, and emotional withdrawal be rated at not more than “moderate” severity (score of ≥4). Comparable to the results by Sethuraman et al6 and Dunayevich et al,7 the Lieberman criteria were more stringent than the new RSWG criteria (pooled remission frequencies at 1 year using severity criteria only = 38% vs 48%; LOCF). The criteria proposed by Liberman et al11 were less restrictive (pooled remission frequencies at 1 year severity criteria only: 69%; LOCF).