Background: Studies describing long-term continuous care of outpatients with schizophrenia are relatively scarce. The prospective European Schizophrenia Outpatient Health Outcomes study (SOHO) provides data on a cohort of schizophrenic patients over a period of three years.
Methods: Prospective, long-term, observational study including outpatients who initiate therapy or change to a new antipsychotic. The study was designed to provide two patient groups of approximately equal size: treated either with olanzapine or a non-olanzapine antipsychotic. Sociodemographic, clinical and disease characteristics at baseline were described. Clinical severity of symptoms was assessed at each visit using the Clinical Global Impression scale (CGI). Treatment outcomes were analyzed as treatment discontinuation, remission and relapse rates.
Results: French results are presented in this report. Nine hundred and thirty-three patients (62% males) were recruited between March and December 2001. The mean age was 37.1+/-11.5 years. The mean time since first consultation for schizophrenia was 8.0+/-9.3 years. At study baseline, one quarter had paid employment, less than one third had a spouse or partner and more than half of them had an independent housing. Thirty percent of patients reported a previous suicide attempt. The mean CGI was 4.5+/-1.0 at admission. Overall, medication discontinuation for any cause occurred for 42% of patients. A remission (defined by a CGI<or=3 maintained for 6 months, without hospitalization) was obtained in 63% of patients, 49% of patients relapsed (defined as hospitalization or CGI increase reaching 4 or more) during the three-year follow-up period. A suicide attempt occurred in 60 patients (cumulative proportion 7%).
Conclusions: The clinical findings of the French cohort of patients confirmed the high burden of the disease. Identification of risk factors for discontinuation of treatment should provide a better individualization of patient care and a better impact on the different domains of effectiveness.