The Importance of Remission in the Treatment of Patients with Schizophrenia Spectrum Syndromes Clinical Long-term Investigation of Psychosis in Sweden

Abstract: The goal of this thesis was to investigate the hypothesis whether symptomatic remission for patents with schizophrenia spectrum syndrome would provide practical and qualitative benefits for patients and for society.The first work (Paper I) examines the relationship between cross-sectional remission and the patients’ practical resources. The patients’ adaptations to society as well as their employments, living situations and social networks were studied. Their activity of daily living resources are described in terms of the extent to which they could pursue various undertakings autonomously. Their need for care was also studied. The results showed that the patient group that had achieved remission scored better on all of the variables studied, had better resources and less need for medical care and sheltered housing.The second work (Paper II) analysed the relationship between cross-sectional remission and quality of life, burden placed on patients by the illness, and the patients’ satisfaction with care received and with their medication, and also their capacity for understanding their symptoms and their illness. Even the results of this study showed that the patients in the remission group had a better quality of life, bore a lesser burden, were more satisfied with their care and had better insight into their illness.The third work (Paper III) studied the patients’ neurocognitive capacity to see if a higher capacity resulted in a higher percentage of patients achieving remission. The results showed unequivocally that the patients in remission consistently performed better in the cognitive tests. They also showed that they even had a larger vocabulary indicating a higher premorbid capacity.The fourth work (Paper IV) followed the patients over an average time of 65 months. In this study, the patients’ needs for medical care and for housing were investigated. Patients who were not in cross-sectional remission at baseline had for all the measured variables a higher consumption than those in remission even if the differences were not significant, except for patients who lived in sheltered housing and who had greater need for medical care.Taking all these findings together, the result of this thesis shows that the attainment of remission provides practical and qualitative advantages to the patients and to society.