Abstract:
:Instrument-based scores are often used as outcome measures. However, little is known about what changes in scores mean in terms of a clinical assessment of improvement or deterioration. The purpose of this report was to determine how much change in standard instrument scores represents a clinically detectable improvement or deterioration. The Veterans Affairs (VA) Cooperative Study of Clozapine in Refractory Schizophrenia evaluated 423 patients on clozapine or haloperidol. Symptoms and quality of life scales were completed at baseline; 6 weeks; and 3, 6, and 12 months. Among patients judged as "improved" by clinicians, the average percentage changes were a 21 percent decrease in Positive and Negative Syndrome Scale (PANSS) scores and a 26 percent increase in Quality of Life Scale (QLS) scores across all followup periods. The change in mean seven-point item scores were -0.46 (PANSS) and 0.23 (QLS). A major gain in clinically assessed improvement to "much better" was associated with a 45 percent decline in PANSS scores and 50 percent increase in QLS scores (change in mean seven-point item scores -0.88 and 0.92, respectively). Thus, modest changes in psychometric scales assessing symptoms and quality of life reflect clinically detectable improvement.
journal_name
Schizophr Bulljournal_title
Schizophrenia bulletinauthors
Cramer J,Rosenheck R,Xu W,Henderson W,Thomas J,Charney D,Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia.doi
10.1093/oxfordjournals.schbul.a006869keywords:
subject
Has Abstractpub_date
2001-01-01 00:00:00pages
227-34issue
2eissn
0586-7614issn
1745-1701journal_volume
27pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::This article focuses on the schizophrenic disorganization syndrome, which was initially described by Bleuler (who used the term "dissociation") as lying at the heart of schizophrenia. While adopting a neo-Bleulerian approach, we describe schizophrenic disorganization using a pathogenetic hypothesis and a three-part st...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a007019
更新日期:2003-01-01 00:00:00
abstract::In response to my discussion of sex differences in concordance rates for schizophrenia in twins, Lewine (1979) noted that male schizophrenics are hospitalized earlier than females. He questioned whether females had been followed through the risk period. To clarify, I calculated the age at followup of discordant twins ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/5.1.8
更新日期:1979-01-01 00:00:00
abstract::Evidence for the existence of a genetic factor in the etiology of a significant proportion of the people diagnosed as having a schizophrenic disorder is reviewed. It is suggested that whatever is transmitted genetically need not be inherently pathologic and/or pathogenic. It is argued that only people who have certain...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/5.3.453
更新日期:1979-01-01 00:00:00
abstract::Designs of clinical trials that will permit evaluation of independent, additive, and interactive effects of drugs and psychosocial treatments are described. The central feature of such designs is that they incorporate control conditions for both classes of treatment. Data from the articles in this issue are drawn upon...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/6.1.131
更新日期:1980-01-01 00:00:00
abstract::This study examined the course of illness and factors affecting it in schizophrenias with onset between the ages of 14 and 18. Noteworthy in comparison to findings from other followup studies is the higher proportion of chronic courses of illness, about 50 percent. In addition, the type of course of illness correspond...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/19.4.831
更新日期:1993-01-01 00:00:00
abstract::This article focuses on the cross-modal reaction time paradigm, which has been used to study deviation patterns of shifting attention across stimulus modalities in schizophrenic patients. Cross-modal reaction time research involving pathological and nonpathological populations is reviewed. The influence of sex, stimul...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/6.4.654
更新日期:1980-01-01 00:00:00
abstract::Recent studies provide considerable evidence that schizophrenia and bipolar disorder may share overlapping etiologic determinants. Identifying disease-related genetic effects is a major focus in schizophrenia and bipolar disorder research, with implications for clarifying diagnosis and developing specific treatments f...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbn055
更新日期:2008-07-01 00:00:00
abstract::The success of the biological revolution in our understanding of schizophrenia, along with the lack of convincing evidence for the efficacy of global approaches to individual psychotherapy with schizophrenia, has led to the virtual disappearance of research and theory in this area. However, it seems timely to reexamin...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/15.3.349
更新日期:1989-01-01 00:00:00
abstract::Psychiatric research, including the search for predisposing genes, has tended to proceed under the assumptions that schizophrenia and bipolar disorder, as defined in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and International Statistical Classification of Diseases, 10th Revision, are discr...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/sbm053
更新日期:2007-07-01 00:00:00
abstract::Psychotic-like experiences (PLEs) increase the risk of schizophrenia and other psychotic disorders yet are common in the community. Some PLEs, such as those associated with depression, distress, and poor functioning, may confer increased risk. The aim of this study is to determine the prevalence of PLEs in a nonpsycho...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbj018
更新日期:2006-04-01 00:00:00
abstract::This study examined the content of subscales within a multidimensional scale of self-reported schizotypy and their subsequent interrelationship by means of confirmatory factor analysis (CFA). Neither single-factor nor four-factor models provided good fits to the data; two-factor and three-factor models showed very goo...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033480
更新日期:2000-01-01 00:00:00
abstract::The rapid embracing of artificial intelligence in psychiatry has a flavor of being the current "wild west"; a multidisciplinary approach that is very technical and complex, yet seems to produce findings that resonate. These studies are hard to review as the methods are often opaque and it is tricky to find the suitabl...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbz105
更新日期:2020-01-04 00:00:00
abstract::As a result of improving technologies and greatly increased sample sizes, the last 2 years has seen unprecedented advances in identification of specific genetic risk factors for psychiatric phenotypes. Strong genetic associations have been reported at common polymorphisms within ANK3 and CACNA1C in bipolar disorder an...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbp020
更新日期:2009-05-01 00:00:00
abstract::The diagnosis of schizophrenia is thought to embrace several distinct subgroups. The manifold entities in a single clinical patient group increase the variance of biological measures, deflate the group-level estimates of causal factors, and mask the presence of treatment effects. However, reliable neurobiological boun...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbz112
更新日期:2020-04-10 00:00:00
abstract::Pharmacologic agents currently used or being studied for the treatment of schizophrenia are reviewed. Neuroleptic medications are still the mainstay of treatment, but recent studies suggest new approaches to dosage and to the treatment of acute psychosis. Lithium is beneficial in psychotic illnesses with acute onset a...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/9.4.504
更新日期:1983-01-01 00:00:00
abstract::Evidence suggests that dissociation is associated with psychotic experiences, particularly hallucinations, but also other symptoms. However, until now, symptom-specific relationships with dissociation have not been comprehensively synthesized. This is the first prospectively registered (CRD42017058214) meta-analysis t...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbaa037
更新日期:2020-03-18 00:00:00
abstract::Research on the effectiveness of short-term education programs in changing societal attitudes about mental illness has been mixed. Education efforts seem to be mediated by characteristics of the program participants. This study determines whether the effects of a specially prepared, semester-long course on severe ment...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/oxfordjournals.schbul.a033392
更新日期:1999-01-01 00:00:00
abstract::Child maltreatment is a widespread public health problem associated with a range of mental health disorders later in life. In order to effectively address these disorders, there is a need to understand more about the mental health consequences of different types of child maltreatment. This study examines the associati...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbw175
更新日期:2017-09-01 00:00:00
abstract::Psychophysiological anomalies in symptomatic schizophrenic patients, remitted schizophrenic patients, and individuals at heightened risk for a schizophrenic disorder are reviewed with an emphasis on electrodermal anomalies. Two electrodermal anomalies are identified in different subgroups of symptomatic patients: (1) ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/10.2.204
更新日期:1984-01-01 00:00:00
abstract::Recently published data from the Roscommon Family Study show that a parental diagnosis of schizotypal disorder (SPD) has a significant and specific impact on the risk for schizophrenia in siblings of index probands with schizophrenia spectrum disorders. The distribution patterns of risks for schizophrenia and SPD in p...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/22.2.191
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:Impaired cognition is an important dimension in psychosis and its at-risk states. Research on the value of impaired cognition for psychosis prediction in at-risk samples, however, mainly relies on study-specific sample means of neurocognitive tests, which unlike widely available general test norms are difficu...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbu025
更新日期:2014-11-01 00:00:00
abstract::Family interventions for first-episode psychosis (FEP) are an integral component of treatment, with positive effects mainly on patients' mental state and relapse rate. However, comparatively little attention has been paid to the effects of family interventions on caregivers' stress coping and well-being, especially in...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,随机对照试验
doi:10.1093/schbul/sbw054
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:Cannabis use is associated with a younger age at onset of psychosis, an indicator of poor prognosis, but better cognitive function, a positive prognostic indicator. We aimed to clarify the role of age at onset and cognition on outcomes in cannabis users with first-episode schizophrenia as well as the effect o...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbq153
更新日期:2012-06-01 00:00:00
abstract::In 1917, Eugen Bleuler published an article (Mendelismus bei Psychosen, speziell bei der Schizophrenie [Mendelism in the Psychoses, especially Schizophrenia]) in response to the recently published first systematic family study of dementia praecox (DP) by Ernst Rüdin, then working under Kraepelin in Munich. Although br...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbz131
更新日期:2020-07-08 00:00:00
abstract::Social networks of 35 mentally ill persons were studied in Lao villages. Mental illness was associated with a decrease in size of social networks, disproportionate reliance on family, and asymmetric instrumental exchange. Nonkin "sponsors" provided assistance to those alienated from or abandoned by relatives. For thos...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/7.1.125
更新日期:1981-01-01 00:00:00
abstract::The chronic methamphetamine (MAP) intoxication model of schizophrenia in animals is outlined. The idea originated from the clinical and neurochemical similarities between MAP psychosis and schizophrenia that were found during the decade immediately after World War II when MAP abuse occurred in epidemic proportions in ...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/18.1.107
更新日期:1992-01-01 00:00:00
abstract::Phenotypic heterogeneity within patients and controls may explain why the genetic variants contributing to schizophrenia risk explain only a fraction of the heritability. The aim of this study is to investigate quantitative and qualitative differences in psychosis symptoms in a sample including psychosis patients, the...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbq103
更新日期:2012-05-01 00:00:00
abstract::This study investigated the role of reasoning biases in delusion formation and maintenance. Reasoning judgments have been shown to be influenced by prior knowledge, beliefs, and experience--that is, information stored in semantic memory. It was hypothesized that high schizotypes would exhibit a "jump to conclusions" s...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/sbi012
更新日期:2005-01-01 00:00:00
abstract::Secondary prevention in schizophrenia is still not good enough, and the authors of the articles in this issue of Schizophrenia Bulletin present important new knowledge that may increase earlier detection and treatment. This final article discusses some of their main findings in relation to clinical consequences and ne...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章,评审
doi:10.1093/schbul/22.2.347
更新日期:1996-01-01 00:00:00
abstract::Staff members from nine mental health agencies were trained in psychiatric rehabilitation technology. The trainers then received intensive followup to assist them in implementing the technology in their own agencies. Evaluation of the impact of the "training of trainers" strategy suggested that mental health workers w...
journal_title:Schizophrenia bulletin
pub_type: 杂志文章
doi:10.1093/schbul/12.4.709
更新日期:1986-01-01 00:00:00