Psychiatry Research
Volume 144, Issue 2 , Pages 153-166 , 15 November 2006

Classifying episodes in schizophrenia and bipolar disorder: Criteria for relapse and remission applied to recent-onset samples

  • Keith H. Nuechterlein

      Affiliations

    • UCLA Department of Psychiatry and Biobehavioral Sciences, 300 UCLA Medical Plaza, Room 2251, Los Angeles, CA 90095-6968, United States
    • Corresponding Author InformationCorresponding author. Tel.: +1 310 825 0036; fax: +1 310 206 3651.
  • ,
  • David J. Miklowitz

      Affiliations

    • Department of Psychology, University of Colorado, Boulder, United States
  • ,
  • Joseph Ventura

      Affiliations

    • UCLA Department of Psychiatry and Biobehavioral Sciences, 300 UCLA Medical Plaza, Room 2251, Los Angeles, CA 90095-6968, United States
  • ,
  • Michael J. Gitlin

      Affiliations

    • UCLA Department of Psychiatry and Biobehavioral Sciences, 300 UCLA Medical Plaza, Room 2251, Los Angeles, CA 90095-6968, United States
  • ,
  • Mitchell Stoddard

      Affiliations

    • UCLA Department of Psychiatry and Biobehavioral Sciences, 300 UCLA Medical Plaza, Room 2251, Los Angeles, CA 90095-6968, United States
  • ,
  • David Lukoff

      Affiliations

    • Saybrook Graduate School, San Francisco, CA, United States

Received 31 January 2000 ,Revised 17 April 2004 ,Accepted 23 April 2004.

References 

  1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. Third Edition-Revised. Washington, D.C: American Psychiatric Press; 1987;
  2. Andreasen NC. Negative symptoms in schizophrenia: definition and reliability. Archives of General Psychiatry. 1982;39:784–788
  3. Bebbington P, Kuipers L. The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychological Medicine. 1994;24:707–718
  4. Brekke JS, Long JD. Community-based psychosocial rehabilitation and prospective change in functional, clinical, and subjective experience variables in schizophrenia. Schizophrenia Bulletin. 2000;26:667–680
  5. Brown GW, Birley JLT. Crises and life changes and the onset of schizophrenia. Journal of Health and Social Behavior. 1968;19:203–214
  6. Brown GW, Birley JLT, Wing JK. Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry. 1972;121:241–258
  7. Carpenter WT, Heinrichs DW, Wagman AMI. Deficit and nondeficit forms of schizophrenia: the concept. American Journal of Psychiatry. 1988;145:578–583
  8. Coryell W, Winokur G. Course and outcome. In:  Paykel ES editors. New York: Handbook of Affective Disorders. Guilford; 1982;p. 93–106
  9. Crow TJ. Molecular pathology of schizophrenia: more than one disease process?. British Medical Journal. 1980;280:1–9
  10. Crow TJ, McMillan JF, Johnson AL, Johnstone EC. The Northwick Park study of first episodes of schizophrenia: II. A randomized controlled trial of prophylactic neuroleptic treatment. British Journal of Psychiatry. 1986;148:120–127
  11. Eaton WW, Thara R, Federman B, Melton B, Liang K. Structure and course of positive and negative symptoms in schizophrenia. Archives of General Psychiatry. 1995;52:127–134
  12. Falloon IRH. Relapse: a reappraisal of assessment of outcome in schizophrenia. Schizophrenia Bulletin. 1984;10:293–299
  13. Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori P, et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Archives of General Psychiatry. 1991;48:851–855
  14. Gilbert PL, Harris MJ, McAdams LA, Jeste DV. Neuroleptic withdrawal in schizophrenic patients: a review of the literature. Archives of General Psychiatry. 1995;52:173–188
  15. Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia?. American Journal of Psychiatry. 1996;153:321–330
  16. Harrow M, Goldberg JF, Grossman LS, Meltzer HY. Outcome in manic disorders: a naturalistic follow-up study. Archives of General Psychiatry. 1990;47:665–671
  17. Herz MI, Simon JC. Prodromal signs of schizophrenia relapse. American Journal of Psychiatry. 1986;143:115–116
  18. Hogarty GE, Anderson CM, Reiss DJ, Kornblith SJ, Greenwald DP, Ulrich RF, et al. Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia: II. Two-year effects of a controlled study on relapse and adjustment. The Environmental–Personal Indicators in the Course of Schizophrenia (EPICS) Research Group. Archives of General Psychiatry. 1991;48:340–347
  19. Hogarty GE, Goldberg SC. Drug and sociotherapy in the aftercare of schizophrenic patients: one-year relapse rates. Archives of General Psychiatry. 1973;28:54–64
  20. Hogarty GE, Anderson CM, Reiss DJ, Kornblith SJ, Greenwald DP, Javna CD, et al. Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One-year effects of a controlled study on relapse and expressed emotion. Archieves of General Psychiatry. 1986;43:633–642
  21. Hogarty GE, McEvoy JP, Munetz M, DiBarry AL, Bartone P, Cather R, et al. Dose of fluphenazine, familial expressed emotion, and outcome in schizophrenia: results of a two-year controlled study. Archives of General Psychiatry. 1988;45:797–805
  22. Kane JM, Rifkin A, Quitkin F, Nayak D, Ramos-Lorenzi J. Fluphenazine vs. placebo in patients with remitted, acute first-episode schizophrenia. Archives of General Psychiatry. 1982;39:70–73
  23. Kane JM, Rifkin A, Woerner M, Reardon G, Sarantakos S, Schiebel D, et al. Low-dose neuroleptic treatment of outpatient schizophrenics. Archives of General Psychiatry. 1983;40:893–896
  24. Kavanagh DJ. Recent developments in expressed emotion and schizophrenia. British Journal of Psychiatry. 1992;160:601–620
  25. Keller MB, Lavori PW, Coryell W, Endicott J, Mueller TI. Bipolar I: a five-year prospective follow-up. Journal of Nervous and Mental Disease. 1993;181:238–245
  26. Krawiecka M, Goldberg D, Vaughan MA. A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatrica Scandinavica. 1977;55:299–308
  27. Lader M. What is relapse in schizophrenia?. International Clinical Psychopharmacology. 1991;9 (suppl):5–9
  28. Leff JP, Wing JK. Trial of maintenance therapy in schizophrenia. British Medical Journal. 1971;3:559–604
  29. Leff JP, Vaughn C. Expressed Emotion in Families: Its Significance for Mental Illness. New York: Guilford; 1985;
  30. Liberman RP, Lillie FJ, Falloon IRH, Harpin EJ, Hutchson W, Stoute BA. Social skills training for relapsing schizophrenics: an experimental analysis. Behavior Modification. 1984;8:155–179
  31. Lieberman JA, Kane JM, Sarantakos S, Gadaleta D, Woerner M, Alvir J, et al. Prediction of relapse in schizophrenia. Archives of General Psychiatry. 1987;44:597–603
  32. Linszen DH, Dingemans PM, Lenior ME, Nugter MA, Scholte WF, van der Does AJW. Relapse criteria in schizophrenia disorders: different perspectives. Psychiatry Research. 1994;54:273–281
  33. Lukoff D, Nuechterlein K, Ventura J. Manual for the Expanded Brief Psychiatric Rating Scale. Schizophrenia Bulletin. 1986;12:578–602
  34. Marder SR, Van Putten T, Mintz J, Lebell M, McKenzie J, May PRA. Low- and conventional-dose maintenance therapy with fluphenazine decanoate: two year outcome. Archives of General Psychiatry. 1987;44:518–521
  35. Marder SR, Van Putten T, Mintz J, McKenzie J, Lebell M, Faltico G, et al. Costs and benefits of two doses of fluphenazine. Archives of General Psychiatry. 1984;41:1025–1029
  36. Miklowitz DJ, Goldstein MJ, Nuechterlein KH, Snyder KS, Doane JA. Expressed emotion, affective style, lithium compliance, and relapse in recent onset mania. Psychopharmacology Bulletin. 1986;22:628–632
  37. Miklowitz DJ, Goldstein MJ, Nuechterlein KH, Snyder KS, Mintz J. Family factors and the course of bipolar affective disorders. Archives of General Psychiatry. 1988;45:225–231
  38. Miller TJ, McGlashan TH, Woods SW, Stein K, Driesen N, Corcoran CM, et al. Symptom assessment in schizophrenic prodromal states. Psychiatric Quarterly. Special Issue. The Eleventh Annual New York State Office of Mental Health Research Conference. 1999;70:273–287
  39. Mintz J, Mintz LI, Arruda MJ, Hwang SS. Treatments of depression and the functional capacity to work. Archives of General Psychiatry. 1992;49:761–768
  40. In:  Müller P editors. Zur Rezidivprophylaxe Schizophrener Psychosen. Stuttgart: Enke; 1982;
  41. Norman R, Malla MG. Prodromal symptoms of relapse in schizophrenia: a review. Schizophrenia Bulletin. 1995;21:527–539
  42. Nuechterlein KH, Dawson ME, Gitlin M, Ventura J, Goldstein MJ, Snyder KS, et al. Developmental processes in schizophrenic disorders: longitudinal studies of vulnerability and stress. Schizophrenia Bulletin. 1992;18:387–425
  43. Nuechterlein KH, Snyder KS, Mintz J. Paths to relapse: possible transactional processes connecting patient illness onset, expressed emotion, and psychotic relapse. British Journal of Psychiatry. 1992;161:88–96
  44. Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychological Reports. 1962;10:799–812
  45. Prien RF, Carpenter LL, Kupfer DJ. The definition and operational criteria for treatment outcome of major depressive disorder: a review of the current research literature. Archives of General Psychiatry. 1991;48:796–800
  46. Shepherd M, Watt D, Falloon I, Smeeton N. The Natural History of Schizophrenia: A Five Year Follow-up Study of Outcome and Prediction in a Representative Sample of Schizophrenics. Psychological Medicine Monograph 16. In: Cambridge, England: Cambridge University Press; 1989;
  47. Spitzer RL, Endicott J. In: Schedule for Affective Disorders and Schizophrenia (SADS). 3rd ed.. New York: New York State Psychiatric Institute; 1978;
  48. Spitzer RL, Endicott J, Robins E. Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry. 1978;35:773–782
  49. Strauss JS, Carpenter WT. The prediction of outcome in schizophrenia: I. Characteristics of outcome. Archives of General Psychiatry. 1972;27:739–746
  50. Strauss JS, Carpenter WT. The prognosis of schizophrenia: rationale for a multidimensional concept. Schizophrenia Bulletin. 1978;4:56–67
  51. Subotnik KL, Nuechterlein KH. Prodromal signs and symptoms of schizophrenic relapse. Journal of Abnormal Psychology. 1988;97:405–412
  52. Vaughn CE, Leff JP. The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology. 1976;15:157–165
  53. Vaughn CE, Snyder KS, Jones S, Freeman WB, Falloon IRH. Family factors in schizophrenic relapse: a California replication of the British research on expressed emotion. Archives of General Psychiatry. 1984;41:1169–1177
  54. Ventura J, Nuechterlein KH, Lukoff D, Hardesty JP. A prospective study of stressful life events and schizophrenic relapse. Journal of Abnormal Psychology. 1989;98:407–411
  55. Ventura J, Green MF, Shaner A, Liberman RP. Training and quality assurance with the Brief Psychiatric Rating Scale: “the drift busters”. International Journal of Methods in Psychiatric Research. 1993;3:221–244
  56. Ventura J, Lukoff D, Nuechterlein KH, Liberman RP, Green MF, Shaner A. Appendix 1: Brief Psychiatric Rating Scale (BPRS) expanded version (4): scales, anchor points, and administration manual. International Journal of Methods in Psychiatric Research. 1993;3:227–244
  57. Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Schizophrenia Bulletin. 1995;21:419–429
  58. Wing JK, Cooper JE, Sartorius N. The Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego Programs. London, England: Cambridge University Press; 1974;
  59. Winokur G, Coryell W, Akiskal HS, Endicott J, Keller M, Mueller T. Manic-depressive (bipolar) disorder: the course in light of a prospective ten-year follow-up of 131 patients. Acta Psychiatrica Scandinavica. 1994;89:102–110
  60. Yung AR, McGorry PD. The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophrenia Bulletin. 1996;22:353–370
  61. Yung AR, Phillips LJ, Yuen HP, Francey SM, McFarlane CA, Hallgren M, et al. Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophrenia Research. 2003;60:21–32
  62. Zubin J, Spring B. Vulnerability—a new view of schizophrenia. Journal of Abnormal Psychology. 1977;86:103–126

PII: S0165-1781(05)00367-7

doi: 10.1016/j.psychres.2004.04.018

Psychiatry Research
Volume 144, Issue 2 , Pages 153-166 , 15 November 2006