C° ešková et al study comparing olanzapine and haloperidol, the rate of clinical response was significantly higher for the olanzapine- treated patients (67.2%) than for the haloperidol-treated patients (29.2%) (Sanger et al 1999). A recently published study comparing clozapine and chlorpromazine in patients with first-episode schizophrenia and schizophreniform disorder reported response rates of 62% for clozapine and 50% for chlorpromazine (Lieberman, Phillips, et al 2003). Finally, in a double blind study the proportion of study subjects responding by week 12 was 55% for those assigned to olanzapine, compared with 46% for those receiving haloperidol (Lieberman, Tollefson, et al 2003). The response rate in the present study was 73%. The difference may be explained by the sample characteristics and methods. In the present sample, mostly drug-naive patients were included, the study was open, and medications were individualized with the potential to change the antipsychotic according to the psychic state. Although the response criteria of all these studies varied, overall the results indicate that patients with first-episode psychosis are highly responsive to anti- psychotic drug treatment, with a trend suggesting that atypical drugs exhibit some degree of superiority over typicals in response rate and time to response. Most of our patients were also treated with atypical antipsychotics. Our expectations of treatment outcomes for patients are evolving. Remission is now a realistic goal. Patients in symptomatic remission will benefit most from psychosocial interventions. A substantial part of our patients fulfilled not only the response criteria but also suggested criteria for remission. In responders we found a significantly higher score on both positive and negative symptoms before treatment including the lack of judgment and insight. Responders had higher scores of initial psychopathology than nonresponders. A marked improvement in responders probably enabled them to understand better that the previous condition had been pathological and they experienced a clear difference between the previous condition and the outcome of acute treatment, thus improving their chance of creating insight. Also the symptoms associated with the cognitive function level (attention, thinking) improved more significantly and they were able to understand better their own personal realities. In the literature, the severity of basal sympto- matology and the early change of symptomatology were considered to be predictors of treatment response. But no single factor was a strong prediction factor. A combination of the factors seemed to be more promising (Awad et al 1994; C° ešková et al 2002). Of interest is also the association between conceptual disorganization and negative symptoms. Possibly, marked disorganization of thinking leads to problems in the contact with reality and in communication. We have not found any study that deals with such aspects of first-episode schizophrenia. The findings are limited by the fact that the study was open and performed under routine clinical conditions. Not all patients were treated according to the standard algorithm. However, our results provide a closer look at the psychopathological profile of patients with first-episode schizophrenia and confirm that at this stage of illness there is a capacity for early and substantial improvement of symptoms. The persistent lack of judgment and insight in about half of patients is a challenge for health professionals and calls for early psychological care and alleviation of psychotic symptoms. Conclusions On average there is a broad spectrum of psychopathology, positive, (primary) negative, and less specific general symptoms present in most patients with first-episode schizophrenia. Despite patients reacting quickly to antipsychotic treatments, some symptoms (lack of judgment and insight, negative symptoms) persist in some patients and may contribute to function impairment and non- compliance. Patients with severe psychopathology may be more responsive to the acute treatment. Psychiatrists should especially try to influence lack of judgment and insight, which in the early stages of illness are important for its future course. Acknowledgments Supported by the Ministry of Education, Czech Republic (project nr CEZ: J07/18/141100001). References Awad AG. 1994. Prediction research of neuroleptic treatment outcome in schizophrenia – state of the art 1978–1993. In Gaebel W, Awad AG (eds). Prediction of neuroleptic treatment outcome in schizophrenia. 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