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Schennach, Rebecca; Riedel, Michael; Obermeier, Michael; Jaeger, Markus; Schmauss, Max; Laux, Gerd; Pfeiffer, Herbert; Naber, Dieter; Schmidt, Lutz G.; Gaebel, Wolfgang; Klosterkoetter, Joachim; Heuser, Isabella; Maier, Wolfgang; Lemke, Matthias R.; Ruether, Eckart; Klingberg, Stefan; Gastpar, Markus; Seemueller, Florian; Spellmann, Ilja; Musil, Richard; Moeller, Hans-Jürgen (2020): What happens with schizophrenia patients after their discharge from hospital? Results on outcome and treatment from a "real-world" 2-year follow-up trial. In: European Archives of Psychiatry and Clinical Neuroscience, Vol. 270, No. 6: pp. 661-671
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Abstract

Aim of the study was to examine the course of schizophrenia patients within 2 years after discharge. Within a multicenter study of the German Competence Network on Schizophrenia, patients suffering from a schizophrenia spectrum disorder were examined regarding their psychopathological improvement, tolerability, and the treatment regime applied during hospitalization and a 2-year follow-up period. Response, remission, the level of everyday functioning, and relapse were furthermore evaluated during the follow-up period using established definitions for these outcome domains. The psychopharmacological treatment was specifically evaluated in terms of a potential association with relapse. 149 patients were available for analysis, with 65% of the patients being in response, 52% in symptomatic remission, and 64% having a satisfiable everyday functioning 2 years after their discharge from hospital. Despite these favorable outcome rates, 63% of the patients suffered from a relapse within the 2-year follow-up period with 86% of these patients being rehospitalized. Discharge non-responder and non-remitter were twice as likely to relapse during follow-up. A significant decrease of side-effects was observed with negligible rates of extrapyramidal side-effects, sedation, and weight gain during follow-up. Patients receiving treatment with atypical antipsychotics were found to have the lowest risk to relapse (p < 0.0001). The results highlight the natural and unsteady course of schizophrenia in most patients underlining the need to develop more specific treatment strategies ensuring ongoing stability and preventing relapse.