Understanding the course of persistent symptoms in schizophrenia: Longitudinal findings from the pattern study

Josep Maria Haro*, Carlo Altamura, Ricardo Corral, Helio Elkis, Jonathan Evans, Marie Odile Krebs, Mathias Zink, Ashok Malla, José Ignacio Méndez, Corrado Bernasconi, Justine Lalonde, Anna Lena Nordstroem

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

26 Citations (Scopus)
432 Downloads (Pure)


The Pattern study was conducted to provide longitudinal observational data for individual patients with persistent symptoms of schizophrenia. Pattern is an international, multicenter, non-interventional, prospective cohort study of schizophrenia outpatients who were not considered to be in recovery. In the longitudinal phase reported herein, patients were assessed over 1 year using different clinical rating scales. Patient management followed routine local clinical practice. Primary outcome was disease state, defined by the Positive and Negative Syndrome Scale (PANSS), Negative Symptom Factor Score (NSFS), Positive Symptom Factor Score (PSFS), and Personal and Social Performance (PSP) Scale. In total, 1344 protocol-compliant patients (70.9% male) were included. Patients showed a high stability in disease state between consecutive study visits. Persistent negative persistent symptoms and symptomatic remission were the most prevalent and stable disease states. Patients in relapse generally transitioned to negative persistent symptoms or to symptomatic remission. PANSS, PSP, and quality of life ratings remained relatively stable. Relapses occurred in 10% of patients; probability of relapse was associated with younger age, extra-pyramidal symptoms, and more antipsychotic medications. Despite treatment, schizophrenia symptoms tend to remain stable over time, without overall improvement. One of the greatest challenges in schizophrenia is attainment of full symptom remission.

Original languageEnglish
Pages (from-to)56-62
Number of pages7
JournalPsychiatry Research
Early online date10 Apr 2018
Publication statusPublished - 1 Sept 2018


  • Naturalistic
  • Negative symptoms
  • Positive symptoms
  • Recovery
  • Relapse
  • Remission


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