Incomplete remission and treatment resistance in first-episode psychosis: definition, prevalence and predictors

Expert Opin Pharmacother. 2008 Aug;9(12):2027-38. doi: 10.1517/14656566.9.12.2027.

Abstract

Background: Up to 50% of first-episode psychosis patients suffer from long-term incomplete remission or treatment resistance. Different definitions for these terms have been used in psychiatric research, making generalized statements about the prevalence and predictors of treatment resistance difficult.

Objective: The aim of this study was to give an overview on state-of-the-art definitions of treatment resistance for each of the diagnoses making up the inhomogeneous diagnostic entity 'psychosis' and to analyze the factors leading to treatment resistance.

Methods: A computerized and manual literature search for relevant articles published within recent years was undertaken.

Results: In addition to symptomatic criteria, patients' functional level and quality of life have to be considered in the definition of treatment resistance. Patient-related, illness-related and treatment-related predictors of treatment resistance and incomplete remission might help to identify subjects at risk and optimize interventions.

Publication types

  • Review

MeSH terms

  • Drug Resistance*
  • Humans
  • Prevalence
  • Prognosis
  • Psychotic Disorders* / diagnosis
  • Psychotic Disorders* / epidemiology
  • Psychotic Disorders* / therapy
  • Recurrence
  • Remission Induction
  • Treatment Failure