Early Improvement of Psychiatric Symptoms with Long-Acting Injectable Antipsychotic Predicts Subsequent Social Functional Remission in Patients with Schizophrenia

Takashi Ohnishi,1 Akihide Wakamatsu,1 Hisanori Kobayashi2 1Medical Affairs Division, Janssen Pharmaceutical K.K., Tokyo, Japan; 2Research and Development Clinical Science Division, Janssen Pharmaceutical K.K., Tokyo, JapanCorrespondence: Takashi OhnishiMedical Affairs Division, Janssen Pharmaceutical K.K., 5-2, Nishi-kanda 3-chome Chiyoda-ku, Tokyo, 101-0065, JapanTel +81-3-4411-7700Fax +81-3-4411– 5031Email tohnish8@its.jnj.comPurpose: The aim of this study was to clarify whether early symptomatic improvement in response to a long-acting injectable antipsychotic (LAI) contributes to subsequent social functional remission in patients with schizophrenia using the previous clinical trial data (EudraCT registration number: 2011-004889-15). Associations between other factors and social functional remission were also explored.Patients and Methods: We analyzed 428 patients with schizophrenia in which the personal and social performance scale (PSP) and the involvement evaluation questionnaire (IEQ) at the time of the base line were recorded. Social functional remission was defined as participants who scored PSP > 70 at the end of 65 weeks. Logistic regression analyses were done to examine associations between social functional remission and clinical and demographic characteristics including early symptomatic response evaluated by Positive and Negative Syndrome Scale (PANSS) at week one.Results: One hundred out of 428 patients showed social functional remission at the end of the observation period. Shorter duration of illness, higher baseline score of supervision evaluated by IEQ and higher baseline PSP were significantly associated with the social functional remission. Improvement of positive subscale of PANSS at one week was significantly associated with later social functional remission when baseline PSP scores were excluded from predictive variables.Conclusion: Shorter duration of illness, residual type of schizophrenia, higher baseline score of supervision and higher baseline social functioning were predictors of subsequent social functional remission. Although its effect seems to be limited, early symptomatic improvement could be also was a predictor of social functional remission.Keywords: schizophrenia, social function, functional outcome, long-acting injectable antipsychotics; LAI