Remission in early psychosis: Rates, predictors, and clinical and functional outcome correlates ☆ Robin Emsley a , Jonathan Rabinowitz b, ⁎ , Rossella Medori c Early Psychosis Global Working Group a University of Stellenbosch, Tygerberg, Cape Town, South Africa b Bar Ilan University, Israel c Janssen-Cilag EMEA, Beerse, Belgium Received 23 June 2006; received in revised form 12 September 2006; accepted 12 September 2006 Available online 7 November 2006 Abstract Background: Recently, the “Remission in Schizophrenia Working Group” proposed remission criteria consisting of a reduction to mild levels on key symptoms for at least 6 months. Aims: This study applied these remission criteria to a large first-episode psychosis sample in order to (1) determine the rates of remission; (2) explore predictors of remission; and (3) test the external validity of these criteria. Methods: We analyzed data from 462 subjects with a first-episode of psychosis who participated in a long-term, multinational, randomized, double-blinded trial of risperidone and haloperidol over 2 to 4 years. Results: At some time point in the study 323 (70%) of the 462 subjects had a reduction to mild levels on the key symptoms as measured by the PANSS although only 109 (23.6%) maintained this level for at least 6 months thereby meeting remission criteria. The two strongest predictors of remission were shorter duration of untreated psychosis ( p = 0.01) and treatment response at 6 weeks ( p =0.001). Compared to non-remitted patients, those in remission experienced greater improvement on all PANSS subscales ( p b .0001), CGI-S ( p b .0001), better quality of life ( p = 0.006), fewer relapses ( p b .0001), displayed a more favorable attitude towards their medication ( p = .002), had lower EPS levels according to the ESRS ( p = b .0001) and received lower doses of antipsychotic medication ( p = 0.003). The remission and non-remission groups did not differ significantly regarding composite cognitive scores, suicidality and body mass index. Schizophrenia Research 89 (2007) 129 – 139 www.elsevier.com/locate/schres ☆ The randomized controlled drug trial presented in this paper was funded by Johnson and Johnson Pharmaceutical Research and Development. The study included the following investigators and locations: Australia - P. McGorry (Melbourne); T. Lambert (Bentley); J. Kulkarni (Dandenong); Austria - W. Fleischhacker (Innsbruck); Canada - D. Addington (Calgary); L. Kopala (Halifax); R. Williams (Calgary); G. Chouinard (Montreal); A. Labelle (Ottawa); A. Malla (London); S. Purdon (Edmonton); M. Saxena (Hamilton); V. Nair (Montreal); R. Matte (Sherbrooke); S. Johnson (St. John's); L. Beauclair (Montreal); Finland - K. Lehtinen (Tampere); France - E.R. Lombertie (Limoges); J-A. Meynard (La Rochelle); Germany - H. Freyberger (Stralsund); H-J. Möller (Munich); Israel - A. Caspi; M. Davidson (Ramat-Gan); A. Elitzur (Bat-Yam); M. Kotler (Beer Sheva); I. Treves (Hod-Hasharon); A. Weizman (Petach-Tikva); Netherlands - P. Dries (Portugal); New Zealand - D. Codyre (Auckland); South Africa - R. Emsley (Cape Town); C. Gagiano (Bloemfontein); United Kingdom - M. Reveley (Leicester); T. Sharma (London); United States of America - J. Csernansky (St. Louis); L. DeLisi (Stony Brook); J. Lauriello (Albuquerque); T. Manschreck (Fall River); J. Pahl (Oklahoma City); N. Schooler, M. Keshavan (Pittsburgh); S. Schulz (Cleveland); S. Targum (Philadelphia); S. Risch (Charleston). ⁎ Corresponding author. Tel.: +972 9 748 3679; fax: +972 9 740 1318. E-mail address: jr827@columbia.edu (J. Rabinowitz). 0920-9964/$ - see front matter © 2006 Elsevier B.V. All rights reserved. doi:10.1016/j.schres.2006.09.013