***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: To evaluate the maintenance of efficacy of risperidone long‐acting injectable ( RLAI ) in stable patients with schizophrenia or schizoaffective disorders . The prevalence of patients who met st and ardized remission criteria will be also evaluated as well as the predictors factors of remission according to psychopathological , psychosocial and subjective correlates Background A number of recently published r and omized controlled trials conducted in developed countries have reported no advantage for assertive interventions over st and ard care models . One possible explanation could be that so-called " st and ard care " has become more comprehensive in recent years , incorporating some of the salient aspects of assertive models in its modus oper and i. Our study represents the first r and omised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country . Methods High frequency service users were r and omized into an intervention ( n = 34 ) and a control ( n = 26 ) group . The control group received st and ard community care and the active group an assertive intervention based on a modified version of the international model of assertive community treatment . Study visits were conducted at baseline and 12 months with demographic and illness information collected at visit 1 and readmission rates documented at study end . Symptomatology and functioning were measured at both visits using the PANSS , CDSS , ESRS , WHO-QOL and SOFAS . Results At 12 month follow-up subjects receiving the assertive intervention had significantly lower total PANSS ( p = 0.02 ) as well as positive ( p < 0.01 ) and general psychopathology ( p = 0.01 ) subscales ' scores . The mean SOFAS score was also significantly higher ( p = 0.02 ) and the mean number of psychiatric admissions significantly lower ( p < 0.01 ) in the intervention group . Conclusions Our results indicate that assertive interventions in a developing setting where st and ard community mental services are often under re source d can produce significant outcomes . Furthermore , these interventions need not be as expensive and comprehensive as international , first-world models in order to reduce inpatient days , improve psychopathology and overall levels of functioning in patients with severe mental illness BACKGROUND Recently , remission criteria for schizophrenia have been proposed , based on low symptom severity of core symptoms ( severity criterion ) , sustained over minimally 6 months ( time criterion ) . Little is known , however , about the added value of the time criterion in addition to the cross-sectional severity criterion . METHODS In order to evaluate whether remission is a valid concept for daily clinical practice , the cumulative incidence of patients meeting remission criteria  was evaluated in a large naturalistic prospect i ve study of patients with schizophrenia or schizoaffective disorder in different treatment setting s in Belgium . The impact of being in remission on global and daily functioning was evaluated . RESULTS Over time , nearly 1 out of 3 patients with a diagnosis of schizophrenia or schizoaffective disorder ( 29 % ) met criteria for remission at study endpoint . Patients in remission had better insight in their disorder , a higher level of global functioning and functioned better with respect to daily living tasks , both compared to patients never meeting remission criteria and to patients only meeting the severity criterion but not the time criterion . Of the patients not meeting remission criteria at baseline , 21 % attained remission at study endpoint . CONCLUSION The remission severity and time criteria appear to combine into a valid concept for daily clinical practice and should be a target for treatment BACKGROUND Recently , the " Remission in Schizophrenia Working Group " proposed remission criteria consisting of a reduction to mild levels on key symptoms for at least 6 months . AIMS This study applied these remission criteria to a large first-episode psychosis sample in order to ( 1 ) determine the rates of remission ; ( 2 ) explore predictors of remission ; and ( 3 ) test the external validity of these criteria . METHODS We analyzed data from 462 subjects with a first-episode of psychosis who participated in a long-term , multinational , r and omized , double-blinded trial of risperidone and haloperidol over 2 to 4 years . RESULTS At some time point in the study 323 ( 70 % ) of the 462 subjects had a reduction to mild levels on the key symptoms as measured by the PANSS although only 109 ( 23.6 % ) maintained this level for at least 6 months thereby meeting remission criteria . The two strongest predictors of remission were shorter duration of untreated psychosis ( p=0.01 ) and treatment response at 6 weeks ( p=0.001 ) . Compared to non-remitted patients , those in remission experienced greater improvement on all PANSS subscales ( p<.0001 ) , CGI-S ( p<.0001 ) , better quality of life ( p=0.006 ) , fewer relapses ( p<.0001 ) , displayed a more favorable attitude towards their medication ( p=.002 ) , had lower EPS levels according to the ESRS ( p=<.0001 ) and received lower doses of antipsychotic medication ( p=0.003 ) . The remission and non-remission groups did not differ significantly regarding composite cognitive scores , suicidality and body mass index . CONCLUSIONS The results suggest that the remission criteria , although based solely on core symptom improvement , can effectively identify patients who have a more favorable overall outcome OBJECTIVE This study examined the treatment response of patients with first-episode schizophrenia and schizoaffective disorder and potential predictors of response . METHOD First-episode patients were assessed on measures of psychopathology , cognition , social functioning , and biological parameters and treated according to a st and ardized algorithm . RESULTS One hundred eighteen patients ( 52 % male , mean age 25.2 years ) entered the study . The cumulative percentage of patients responding by 1 year was 87 % ; the median time to response was 9 weeks . The following variables were significantly associated with less likelihood of response to treatment : male sex , obstetric complications , more severe hallucinations and delusions , poorer attention at baseline , and the development of parkinsonism during antipsychotic treatment . Variables not significantly related to treatment response were diagnosis ( schizophrenia versus schizoaffective disorder ) , premorbid functioning , duration of psychotic symptoms prior to study entry , baseline disorganization , negative and depressive symptoms , baseline motor function , akathisia and dystonia during treatment , growth hormone and homovanillic acid measures , psychotic symptom activation to methylpheni date , and magnetic resonance measures . CONCLUSIONS Patients with first-episode schizophrenia and schizoaffective disorder have high rates of response to antipsychotic treatment ; there are specific clinical and pathobiologic predictors of response OBJECTIVE Switching medications is common in the treatment of schizophrenia . This study examines the effectiveness of olanzapine therapy following a clinical ly warranted switch from risperidone during treatment of patients with schizophrenia . RESEARCH DESIGN AND METHODS This post-hoc analysis used data from the risperidone arm of a r and omized , open-label , 1-year study of patients with schizophrenia . Study protocol permitted antipsychotic switching when clinical ly warranted , and outcomes were assessed with st and ard psychiatric measures . Statistical analyses assessed changes from pre- to post-medication switch and endpoint comparisons between patients switched from risperidone to olanzapine and patients continued on risperidone . RESULTS Most patients who switched from risperidone  switched to olanzapine ( 43/60 ; 71.7 % ) . Average duration of risperidone  treatment prior to switching was 86 days ( mean modal dose 4.0 mg/day ) . Most switchers ( 86 % ) completed the 1-year study on olanzapine ( average duration 241 days ; mean modal dose 12.0 mg/day ) . Following switch to olanzapine , patients experienced significant improvements on clinical ( Brief Psychiatric Rating Scale ) and social ( Quality of Life Inventory ) parameters , with similar proportions of patients achieving remission status at endpoint compared with risperidone patients not requiring medication switch ( 41.9 vs. 35.5 % ) . Mean weight gain for switchers was approximately 0.4 kg while on risperidone ( average treatment duration < 3 months ) and 2.4 kg on olanzapine ( average treatment duration approximately 8 months ) . CONCLUSIONS This study suggests that olanzapine is an effective treatment option for schizophrenia patients requiring a switch from risperidone .  Given the small sample size and lack of a comparative group , one can not determine if other medication options would have been as effective as the switch to olanzapine . Thus , further research is warranted Although the concept of remission has been widely accepted and utilized in depression and anxiety disorders , there has been much less emphasis on defining remission in schizophrenia . Recently , an expert consensus definition of remission in schizophrenia was proposed along specific operational criteria for the attainment of remission focusing on the three core dimensions of psychopathology identified within schizophrenia : psychoticism , disorganization and negative symptoms . To date , the criteria have been applied retrospectively to several clinical studies , and these have demonstrated that the proposed definition of remission correlates significantly with established measures of symptom severity , functioning and quality of life , and appears achievable for a significant proportion of patients receiving at least 3 months of pharmacotherapy . In this article we extend the notion of remission to include an examination of the possible association of several modifiable and unmodifiable factors and co-morbidities on remission status . We also propose an investigation into the likelihood of different patient population s in achieving remission as well as assessing the impact of remission on health care costs and family burden . Since cognitive dysfunction and negative symptoms may be strongly correlated with a lower likelihood of achieving remission , we recommend retrospective and /or prospect i ve studies to determine the relationship between neurocognitive status and the predominance of negative symptoms at treatment start and the probability of achieving remission . Taken together , these studies should help identify key predictors of remission , further define the remitted state , reduce therapeutic pessimism , raise treatment expectations and chart a strategy for further research in this important area PURPOSE Although treatment advances have improved outcomes in schizophrenia , definitions of remission and recovery are still evolving . Recently proposed criteria for remission ( mild or less on multiple core-symptom ratings for at least 6 months ) have been applied to a 1-year study of long-acting risperidone injection . METHODS In a 50-week , open-label trial , stable patients with schizophrenia or schizoaffective disorder who received long-acting risperidone injection every 2 weeks were assessed using the Positive and Negative Syndrome Scale ( PANSS ) . Remission criteria for the PANSS were applied ; global illness severity ( Clinical Global Impressions ) and patient-rated health status ( 36-Item Short-form Health Survey ) were measured . RESULTS Groups were identified by initial remission status ( excluding the time component ) . Although considered clinical ly " stable , " 68.2 % ( 394/578 ) did not meet the symptom-severity component of remission criteria at baseline . Following long-acting , injectable risperidone treatment , 20.8 % ( 82 ) of nonremitted patients achieved symptom remission for at least 6 months , with significant decreases in mean PANSS total and cluster scores ( P < 0.0001 ) and significantly improved patient-rated health status ( P < 0.0001 ) . Percentages rated as not ill , very mild , or mild increased from 39 % to 88 % . Among 31.8 % ( 184/578 ) of patients meeting the symptom-severity component of remission criteria at baseline , 84.8 % ( 156 ) maintained these criteria at endpoint . CONCLUSIONS Among previously " stable , " nonremitted patients , many achieved symptom remission after long-acting , injectable risperidone treatment , with significant improvements in multiple symptom domains and patient-rated health status . These results warrant further study as these remission criteria may represent a meaningful clinical endpoint and an important step towards functional recovery BACKGROUND The goal of these secondary analyses of clinical trial data was to characterize clinical outcomes in patients with schizophrenia who met symptom severity or duration thresholds for two alternative definitions of remission , and to explore their relationships to improvement duration and quality of life outcomes . METHODS Definition 1 used threshold criteria for selected PANSS items sustained over at least 6-months Definition 2 used Brief Psychiatric Rating Scale ( BPRS ) % change , a threshold score for the Clinical Global Improvement-Severity ( CGI-S ) maintained for at least 8 weeks , and threshold scores for selected BPRS items . Positive and Negative Symptom Scale ( PANSS ) and Quality of Life scale ( QLS ) total scores were pooled from 6 clinical trials . The extent to which the alternative severity thresholds from these two definitions and duration of clinical improvement were associated with different clinical and QLS outcomes was explored . Regression analysis also assessed the relative contribution of each of the components of the two definition severity thresholds to improvements in QLS Total score . RESULTS Increases in QLS scores were greater for those patients who met either threshold criteria relative to those who met neither ( p<.0001 ) . Significantly greater improvements in QLS scores were observed for patients who met either threshold criteria at the 8- , 16- and 24-week visits relative to those who met criteria at weeks 16 and 24 , or at week 24 only ( p<0.001 ) , as well as for the subset of patients who met threshold criteria at both 24 and 52 weeks relative to those who met criteria at only one of these 2 time points . Only 31 % to 47 % 
    Output:
    
Patients who were treated with long-acting injectable risperidone  showed high maintenance of remission status .
Studies comparing second-generation antipsychotics versus haloperidol showed higher remission rates for the former .
The variables most frequently associated with remission were better premorbid function , milder symptoms at baseline ( especially negative symptoms ) , early response to treatment , and shorter duration of untreated psychosis .
Variability in the length and frequency of follow-ups , as well as differences in dropout rates , could partially explain the differences in reported rates .
Rates of symptomatic remission exceeded reported rates for functional recovery .