Australian & New Zealand Journal of Psychiatry 2015, Vol. 49(3) 266–274 DOI: 10.1177/0004867414557680 © The Royal Australian and New Zealand College of Psychiatrists 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav anp.sagepub.com Australian & New Zealand Journal of Psychiatry, 49(3) Introduction The inevitability of poor outcome for patients with schizo- phrenia has been successfully challenged (De Hert et al., 2007), suggesting that the course of illness is more variable than previously understood. Approximately 80% of the patients with schizophrenia are not characterized by a decline (Bellack, 2006). This has led to a more optimistic perspective on the possibilities of many patients with schiz- ophrenia and paved the way for the conceptualization of remission criteria. In 2005, the Remission in Schizophrenia Working Group (RSWG) (Andreasen et al., 2005) conceptualized the remis- sion criteria for schizophrenia. Remission was defined by both a severity and a time criterion, i.e. remission is achieved when eight symptoms do not exceed a score of mild (severity criterion) for at least 6 months or more (time criterion). These core symptoms together represent the psy- chotic, disorganized and negative symptom dimensions of schizophrenia (Andreasen et al., 2005; Van Os et al., 2006). Remission criteria and functional outcome in patients with schizophrenia, a longitudinal study Henriette D Heering 1* , Mayke Janssens 2* , Lindy-Lou Boyette 1 , Neeltje EM van Haren 3 and G.R.O.U.P investigators Abstract Background: The Remission in Schizophrenia Working Group (RSWG) has proposed remission criteria for schizo- phrenia, which were shown to be valid in terms of functional and clinical outcomes. However, studies investigating the association between dynamics in remission status in relation to longitudinal functional and clinical outcome are scarce. Methods: A total of 648 patients were allocated to four change-in-remission groups, i.e. remission/remission, remis- sion/no-remission, no-remission/remission, and no-remission/no-remission. Remission status was based on PANSS rat- ings. Multilevel linear modelling techniques were used to investigate whether enduring remission was associated with more improvement in functional outcome at follow-up. Further, change in functional and clinical outcome at follow-up measurement was assessed for each remission category separately. Results: Both at baseline and at follow-up, remission status was associated with better functioning. At baseline, patients who subsequently moved out of remission status could be characterized by more severe psychopathology, disabilities, unmet needs and worse quality of life (QoL) compared with patients who continued to be in remission. The stable in- remission group was characterized by significantly better functioning and QoL, both at baseline and follow-up compared with all other remission groups. Nevertheless, QoL increased in all four patient categories. Conclusions: In a large sample of patients with a non-affective psychotic disorder, stable remission or moving into remission over time, based on the RSWG criteria, was associated with a favourable functional outcome and QoL, provid- ing further support for the clinical validity of the RSWG remission criteria. The findings also suggest growing adaptation and self-management over time, despite ongoing difficulties. Keywords Remission criteria, schizophrenia, functional outcome 1 Academic Medical Center, Department of Psychiatry, Amsterdam, the Netherlands 2 Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands 3 University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, the Netherlands *Joint first authors Corresponding author: H.D. Heering, Department of Psychiatry, Academic Medical Center, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands. Email: h.d.heering@amc.uva.nl 557680ANP 0 0 10.1177/0004867414557680Australian & New Zealand Journal of PsychiatryHeering et al. research-article 2014 Research at University of Groningen on May 27, 2015 anp.sagepub.com Downloaded from