Evaluation of the Functional Remission Occurrence and Predictive Factors in Schizophrenia

Study Overview
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Brief Summary
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In a population of patients suffering from schizophrenia being treated for an episode of clinical destabilization and followed for a period of twelve months, the main objective is to evaluate the proportion of patients achieving functional remission and its relationship to clinical remission.

Detailed Description
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Prospective, national, noninterventional study. One year follow up with three evaluation dates (D0, D180 and D360). The participation of a subject in this study will in no way impact the regular care of the subject or any benefits they are otherwise entitled to. All treatment decisions will be made at the discretion of the participating physician, in accordance with his clinical practice and with approved local prescribing information. Only data available from clinical practice will be collected. Evaluation methods: patient history and clinical examination, clinical global impression (CGI): Improvement in CGI, social performance evaluation [functional remission of general schizophrenia (FROGS scale)], clinical remission evaluation: 8 items of the Positive and negative syndrome (PANSS) Scale, psychosocial remission evaluation (PSP scale), current insight evaluation: insight scale for psychosis, subjective well being under neuroleptic treatment (SWN scale), health condition [Euro quality of life - 5 Dimensions (EQ-5D)]; Judgment Criteria: functional remission is defined as an overall score of greater than or equal to (>=) 57 on the FROGS scale, functional response is defined as improvement of >= 7 points on the FROGS scale. Safety evaluation: no tolerance analysis will be performed, adverse event (AE) and serious adverse event (SAE) with J&J products will be collected and transmitted according to J&J timelines/process.

Official Title
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Evaluation of the Functional Remission Occurrence and Predictive Factors in Schizophrenia

Conditions
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Schizophrenia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients must be male or female adult patients aged 18 to 37 years with a diagnosis of schizophrenia according to diagnostic and statistical manual of mental disorders (DSM-IV) criteria Treated for schizophrenia Having read understood and signed an informed consent (for patients under legal guardianship, the legal guardian will be informed by the physician) Patients must have initiated a long-acting injectable antipsychotic treatment less than 2 months after a previous treatment Patients must have been under monitoring by a treatment team from a hospital, a medical psychiatric centre or a clinic for at least 6 months and must be likely to be followed by the same team for the next year Exclusion Criteria: Resistant schizophrenia (no response after receiving two successive antipsychotic treatments at an effective dose, each over at least a four-week period) Drug or alcohol dependence or abuse (other than nicotine or caffeine abuse) diagnosed according to DSM-IV in the month preceding the study inclusion process which according to the investigator could compromise the participation in the study History of neuroleptic malignant syndrome Inability to comply with the requirements of the study (e.g., intellectual deficiency, inability or unwillingness to answer questionnaires) according to the investigator's opinion Patients under trusteeship or patient receiving psychiatric care without his consent (except patient under care program) Participation in another study within 30 days prior to the study inclusion period

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 37 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Schizophrenia<br>350 patients will be included in the study. The centers selection is planned with 100 hospital-based psychiatrists, in centers for preventive medicine (CMP) or in private settings. Each investigator should consecutively enroll patients fulfilling the selection criteria to participate in the study (mean expected number of participants per center is around 10). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical Remission | Defined by the absence of a score greater than (>) 3 on the Positive and Negative Syndrome Scale (PANSS) 8 item scale at two consecutive evaluations (D0 and D180 or D180 and D360). The PANSS 8 items allows to evaluate the clinical remission, defined by a score less than or equal to (=<) 3 on each eight items during a six month minimum period. Each of the 8 PANSS items must be scored from 1 (not at all) to 7 (extremely). More the score is high, more the severity rate of the symptom is high. | 1 year Follow up | 
| Functional Remission | Defined by Functional Remission of General Schizophrenia (FROGS) scale global score and its relationship with clinical remission. FROGS scale: The Functional Remission of General Schizophrenia (FROGS) is a 19 items scale gathered in five fields (Daily life, Activities, Adaptation Quality, relational Life, Health and treatment) used to evaluate the functional remission in schizophrenia. The 19 items must be scored from 1(not done) to 5 (perfectly done). The total score is 19 to 95. More the score is high, better the functioning abilities are is high. | 1 year Follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional Response | Defined as improvement from baseline of greater than or equal to (>=) 7 points on the FROGS scale. FROGS scale: The Functional Remission of General Schizophrenia (FROGS) is a 19 items scale gathered in five fields (Daily life, Activities, Adaptation Quality, relational Life, Health and treatment) used to evaluate the functional remission in schizophrenia. The 19 items must be scored from 1(not done) to 5 (perfectly done). The total score is 19 to 95. More the score is high, better the functioning abilities are is high. | 1 year Follow up | 
| Satisfactory Level of Functioning | Defined by the absence of an item less than (<) 3 on the FROGS scale. FROGS scale: The Functional Remission of General Schizophrenia (FROGS) is a 19 items scale gathered in five fields (Daily life, Activities, Adaptation Quality, relational Life, Health and treatment) used to evaluate the functional remission in schizophrenia. The 19 items must be scored from 1(not done) to 5 (perfectly done). The total score is 19 to 95. More the score is high, better the functioning abilities are is high. | 1 year Follow up | 
| Predictive Clinical Characteristics | Search for clinical variables predicting an improvement in social performance. | 1 year Follow up | 
| Threshold Score | Determine a threshold score to define functional remission, satisfactory functioning and optimal functioning on the Mini FROGS scale. Mini FROGS: 4 of the 19 items of FROGS, also scored from 1 (not done) to 5 (perfectly done), the total score is 4 to 20. More the score is high, better the functioning abilities are high. | 1 year Follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CNS, Antipsychotic, Functional remission, Observational study, FROGS, PSP, Functioning, Schizophrenia