Clinical Evaluation of Antipsychotic Treatment Response in Schizophrenia

Clinical evaluation of antipsychotic treatment in schizophrenia centres on systematic assessment of symptom change, functional outcomes and tolerability. Standardised rating scales such as the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impressions (CGI) scale quantify core positive, negative and general psychopathology dimensions alongside global severity and improvement. Early identification of non-response or suboptimal response within the first two to four weeks of therapy has emerged as a reliable indicator of longer-term outcomes, guiding decisions on dose adjustment or medication switching. Recent advances include the development of abbreviated symptom scales to reduce assessment burden, the exploration of severity thresholds to predict dropout risk in trials, and the integration of patient-reported outcomes and informant data to enhance measurement precision. Randomised controlled trials remain the gold standard for establishing efficacy, yet pragmatic studies and pooled participant-level analyses have enriched understanding of how baseline illness severity, symptom subtypes and early symptom trajectories interact to influence antipsychotic-placebo separation and functional recovery. Optimising evaluation strategies on a global scale supports personalised treatment pathways, rational drug selection and improved quality of life for people with schizophrenia.

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Clinical Evaluation of Antipsychotic Treatment Response in Schizophrenia publication trend

The graph below shows the total number of articles in clinical evaluation of antipsychotic treatment response in schizophrenia across all publications each year (not limited to Nature Index journals).

Technical terms

Positive and Negative Syndrome Scale (PANSS): A clinician-administered instrument measuring positive, negative and general psychopathology symptoms in schizophrenia.

Clinical Global Impressions (CGI) Scale: A brief tool for rating overall illness severity and global improvement in psychiatric disorders.

Placebo-Controlled Trial: A study design in which one group receives an inactive substance to compare effects against the active treatment.

Non-Response: Failure to achieve a predefined reduction in symptom severity (often <20 per cent on PANSS) after a specified treatment period.

References

1. Early non-response as a predictor of later non-response to antipsychotics in schizophrenia: a randomized trial. BMC Medicine (2023).
2. Initial severity of the Positive and Negative Syndrome Scale (PANSS)-30, its main subscales plus the PANSS-6, and the relationship to subsequent improvement and trial dropout: a pooled participant-level analysis of 18 placebo-controlled risperidone and paliperidone trials. Translational Psychiatry (2023).
3. Are informants required to obtain valid ratings on the Positive and Negative Syndrome Scale (PANSS)?. Schizophrenia (2023).