The heterogeneity of schizophrenia in disease states
Previous presentation: Some of the contents of this paper have been previously presented at the 16th Annual Meeting of the International Society for Technology Assessment in Health Care June 20, 2000 in the Hague, Netherlands and at the 21st Annual Meeting of the Society for Medical Decision Making...
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| Veröffentlicht in: | Schizophrenia research 2004-11, Vol.71 (1), p.83-95 |
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| creator | Mohr, Penny E. Cheng, C.Michael Claxton, Karl Conley, Robert R. Feldman, Jacob J. Hargreaves, William A. Lehman, Anthony F. Lenert, Leslie A. Mahmoud, Ramy Marder, Stephen R. Neumann, Peter J. |
| description | Previous presentation: Some of the contents of this paper have been previously presented at the 16th Annual Meeting of the International Society for Technology Assessment in Health Care June 20, 2000 in the Hague, Netherlands and at the 21st Annual Meeting of the Society for Medical Decision Making as a poster on October 3, 1999 in Reno, NV.
Background: Studies of schizophrenia treatment often oversimplify the array of health outcomes among patients. Our objective was to derive a set of disease states for schizophrenia using the Positive and Negative Symptom Assessment Scale (PANSS) that captured the heterogeneity of symptom responses.
Methods: Using data from a 1-year clinical trial that collected PANSS scores and costs on schizophrenic patients (
N=663), we conducted a
k-means cluster analyses on PANSS scores for items in five factor domains. Results of the cluster analysis were compared with a conceptual framework of disease states developed by an expert panel. Final disease states were defined by combining our conceptual framework with the empirical results. We tested its utility by examining the influence of disease state on treatment costs and prognosis.
Results: Analyses led to an eight-state framework with varying levels of positive, negative, and cognitive impairment. The extent of hostile/aggressive symptoms and mood disorders correlated with severity of disease states. Direct treatment costs for schizophrenia vary significantly across disease states (
F=27.47,
df=7,
p |
| doi_str_mv | 10.1016/j.schres.2003.11.008 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66893724</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0920996403003839</els_id><sourcerecordid>66893724</sourcerecordid><originalsourceid>FETCH-LOGICAL-c388t-e1ccab2fcef4c22602d147806ecb82ef414686a96fe04fa778e535e19a6fd06f3</originalsourceid><addsrcrecordid>eNp9kN9LwzAQx4MoOqf_gUhf9K31kqZp-iLI8BcMfJnPIUsvLqNrZ9IJ8683o4W9-XRwfO57dx9CbihkFKh4WGfBrDyGjAHkGaUZgDwhE1qUecoKqE7JBCoGaVUJfkEuQ1gDAC2gPCcXtMhLXpRiQvhihckKe_TdF7bo-n3S2SQmu99uG-NbpxPXJrULqAMmodc9hityZnUT8HqsU_L58ryYvaXzj9f32dM8NbmUfYrUGL1k1qDlhjEBrKa8lCDQLCWLTcqFFLoSFoFbXZYSi7xAWmlhaxA2n5L7IXfru-8dhl5tXDDYNLrFbheUELLKS8YjyAfQ-C4Ej1Ztvdtov1cU1MGWWqvBljrYUpSqaCuO3Y75u-UG6-PQqCcCdyOgg9GN9bo1Lhw5QeML4sA9DhxGGz8OfdzmsDVYO4-mV3Xn_r_kD07Siho</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>66893724</pqid></control><display><type>article</type><title>The heterogeneity of schizophrenia in disease states</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Mohr, Penny E. ; Cheng, C.Michael ; Claxton, Karl ; Conley, Robert R. ; Feldman, Jacob J. ; Hargreaves, William A. ; Lehman, Anthony F. ; Lenert, Leslie A. ; Mahmoud, Ramy ; Marder, Stephen R. ; Neumann, Peter J.</creator><creatorcontrib>Mohr, Penny E. ; Cheng, C.Michael ; Claxton, Karl ; Conley, Robert R. ; Feldman, Jacob J. ; Hargreaves, William A. ; Lehman, Anthony F. ; Lenert, Leslie A. ; Mahmoud, Ramy ; Marder, Stephen R. ; Neumann, Peter J.</creatorcontrib><description>Previous presentation: Some of the contents of this paper have been previously presented at the 16th Annual Meeting of the International Society for Technology Assessment in Health Care June 20, 2000 in the Hague, Netherlands and at the 21st Annual Meeting of the Society for Medical Decision Making as a poster on October 3, 1999 in Reno, NV.
Background: Studies of schizophrenia treatment often oversimplify the array of health outcomes among patients. Our objective was to derive a set of disease states for schizophrenia using the Positive and Negative Symptom Assessment Scale (PANSS) that captured the heterogeneity of symptom responses.
Methods: Using data from a 1-year clinical trial that collected PANSS scores and costs on schizophrenic patients (
N=663), we conducted a
k-means cluster analyses on PANSS scores for items in five factor domains. Results of the cluster analysis were compared with a conceptual framework of disease states developed by an expert panel. Final disease states were defined by combining our conceptual framework with the empirical results. We tested its utility by examining the influence of disease state on treatment costs and prognosis.
Results: Analyses led to an eight-state framework with varying levels of positive, negative, and cognitive impairment. The extent of hostile/aggressive symptoms and mood disorders correlated with severity of disease states. Direct treatment costs for schizophrenia vary significantly across disease states (
F=27.47,
df=7,
p<0.0001), and disease state at baseline was among the most important predictors of treatment outcomes.
Conclusion: The disease states we describe offer a useful paradigm for understanding the links between symptom profiles and outcomes.</description><identifier>ISSN: 0920-9964</identifier><identifier>EISSN: 1573-2509</identifier><identifier>DOI: 10.1016/j.schres.2003.11.008</identifier><identifier>PMID: 15374576</identifier><language>eng</language><publisher>Amsterdam: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Adult and adolescent clinical studies ; Aggression - psychology ; Biological and medical sciences ; Cluster Analysis ; Cognition Disorders - diagnosis ; Cognition Disorders - epidemiology ; Female ; Follow-Up Studies ; Hostility ; Humans ; Male ; Medical sciences ; Middle Aged ; Mood Disorders - diagnosis ; Mood Disorders - epidemiology ; Outcome assessment ; Outcome Assessment (Health Care) ; Prognosis ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychoses ; Schizophrenia ; Schizophrenia - diagnosis ; Schizophrenia - economics ; Schizophrenia - epidemiology ; Severity of Illness Index ; Treatment costs</subject><ispartof>Schizophrenia research, 2004-11, Vol.71 (1), p.83-95</ispartof><rights>2004 Elsevier B.V.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c388t-e1ccab2fcef4c22602d147806ecb82ef414686a96fe04fa778e535e19a6fd06f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.schres.2003.11.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16114666$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15374576$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mohr, Penny E.</creatorcontrib><creatorcontrib>Cheng, C.Michael</creatorcontrib><creatorcontrib>Claxton, Karl</creatorcontrib><creatorcontrib>Conley, Robert R.</creatorcontrib><creatorcontrib>Feldman, Jacob J.</creatorcontrib><creatorcontrib>Hargreaves, William A.</creatorcontrib><creatorcontrib>Lehman, Anthony F.</creatorcontrib><creatorcontrib>Lenert, Leslie A.</creatorcontrib><creatorcontrib>Mahmoud, Ramy</creatorcontrib><creatorcontrib>Marder, Stephen R.</creatorcontrib><creatorcontrib>Neumann, Peter J.</creatorcontrib><title>The heterogeneity of schizophrenia in disease states</title><title>Schizophrenia research</title><addtitle>Schizophr Res</addtitle><description>Previous presentation: Some of the contents of this paper have been previously presented at the 16th Annual Meeting of the International Society for Technology Assessment in Health Care June 20, 2000 in the Hague, Netherlands and at the 21st Annual Meeting of the Society for Medical Decision Making as a poster on October 3, 1999 in Reno, NV.
Background: Studies of schizophrenia treatment often oversimplify the array of health outcomes among patients. Our objective was to derive a set of disease states for schizophrenia using the Positive and Negative Symptom Assessment Scale (PANSS) that captured the heterogeneity of symptom responses.
Methods: Using data from a 1-year clinical trial that collected PANSS scores and costs on schizophrenic patients (
N=663), we conducted a
k-means cluster analyses on PANSS scores for items in five factor domains. Results of the cluster analysis were compared with a conceptual framework of disease states developed by an expert panel. Final disease states were defined by combining our conceptual framework with the empirical results. We tested its utility by examining the influence of disease state on treatment costs and prognosis.
Results: Analyses led to an eight-state framework with varying levels of positive, negative, and cognitive impairment. The extent of hostile/aggressive symptoms and mood disorders correlated with severity of disease states. Direct treatment costs for schizophrenia vary significantly across disease states (
F=27.47,
df=7,
p<0.0001), and disease state at baseline was among the most important predictors of treatment outcomes.
Conclusion: The disease states we describe offer a useful paradigm for understanding the links between symptom profiles and outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Aggression - psychology</subject><subject>Biological and medical sciences</subject><subject>Cluster Analysis</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hostility</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mood Disorders - diagnosis</subject><subject>Mood Disorders - epidemiology</subject><subject>Outcome assessment</subject><subject>Outcome Assessment (Health Care)</subject><subject>Prognosis</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychoses</subject><subject>Schizophrenia</subject><subject>Schizophrenia - diagnosis</subject><subject>Schizophrenia - economics</subject><subject>Schizophrenia - epidemiology</subject><subject>Severity of Illness Index</subject><subject>Treatment costs</subject><issn>0920-9964</issn><issn>1573-2509</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kN9LwzAQx4MoOqf_gUhf9K31kqZp-iLI8BcMfJnPIUsvLqNrZ9IJ8683o4W9-XRwfO57dx9CbihkFKh4WGfBrDyGjAHkGaUZgDwhE1qUecoKqE7JBCoGaVUJfkEuQ1gDAC2gPCcXtMhLXpRiQvhihckKe_TdF7bo-n3S2SQmu99uG-NbpxPXJrULqAMmodc9hityZnUT8HqsU_L58ryYvaXzj9f32dM8NbmUfYrUGL1k1qDlhjEBrKa8lCDQLCWLTcqFFLoSFoFbXZYSi7xAWmlhaxA2n5L7IXfru-8dhl5tXDDYNLrFbheUELLKS8YjyAfQ-C4Ej1Ztvdtov1cU1MGWWqvBljrYUpSqaCuO3Y75u-UG6-PQqCcCdyOgg9GN9bo1Lhw5QeML4sA9DhxGGz8OfdzmsDVYO4-mV3Xn_r_kD07Siho</recordid><startdate>20041101</startdate><enddate>20041101</enddate><creator>Mohr, Penny E.</creator><creator>Cheng, C.Michael</creator><creator>Claxton, Karl</creator><creator>Conley, Robert R.</creator><creator>Feldman, Jacob J.</creator><creator>Hargreaves, William A.</creator><creator>Lehman, Anthony F.</creator><creator>Lenert, Leslie A.</creator><creator>Mahmoud, Ramy</creator><creator>Marder, Stephen R.</creator><creator>Neumann, Peter J.</creator><general>Elsevier B.V</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041101</creationdate><title>The heterogeneity of schizophrenia in disease states</title><author>Mohr, Penny E. ; Cheng, C.Michael ; Claxton, Karl ; Conley, Robert R. ; Feldman, Jacob J. ; Hargreaves, William A. ; Lehman, Anthony F. ; Lenert, Leslie A. ; Mahmoud, Ramy ; Marder, Stephen R. ; Neumann, Peter J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c388t-e1ccab2fcef4c22602d147806ecb82ef414686a96fe04fa778e535e19a6fd06f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Aggression - psychology</topic><topic>Biological and medical sciences</topic><topic>Cluster Analysis</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hostility</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mood Disorders - diagnosis</topic><topic>Mood Disorders - epidemiology</topic><topic>Outcome assessment</topic><topic>Outcome Assessment (Health Care)</topic><topic>Prognosis</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychoses</topic><topic>Schizophrenia</topic><topic>Schizophrenia - diagnosis</topic><topic>Schizophrenia - economics</topic><topic>Schizophrenia - epidemiology</topic><topic>Severity of Illness Index</topic><topic>Treatment costs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mohr, Penny E.</creatorcontrib><creatorcontrib>Cheng, C.Michael</creatorcontrib><creatorcontrib>Claxton, Karl</creatorcontrib><creatorcontrib>Conley, Robert R.</creatorcontrib><creatorcontrib>Feldman, Jacob J.</creatorcontrib><creatorcontrib>Hargreaves, William A.</creatorcontrib><creatorcontrib>Lehman, Anthony F.</creatorcontrib><creatorcontrib>Lenert, Leslie A.</creatorcontrib><creatorcontrib>Mahmoud, Ramy</creatorcontrib><creatorcontrib>Marder, Stephen R.</creatorcontrib><creatorcontrib>Neumann, Peter J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Schizophrenia research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mohr, Penny E.</au><au>Cheng, C.Michael</au><au>Claxton, Karl</au><au>Conley, Robert R.</au><au>Feldman, Jacob J.</au><au>Hargreaves, William A.</au><au>Lehman, Anthony F.</au><au>Lenert, Leslie A.</au><au>Mahmoud, Ramy</au><au>Marder, Stephen R.</au><au>Neumann, Peter J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The heterogeneity of schizophrenia in disease states</atitle><jtitle>Schizophrenia research</jtitle><addtitle>Schizophr Res</addtitle><date>2004-11-01</date><risdate>2004</risdate><volume>71</volume><issue>1</issue><spage>83</spage><epage>95</epage><pages>83-95</pages><issn>0920-9964</issn><eissn>1573-2509</eissn><abstract>Previous presentation: Some of the contents of this paper have been previously presented at the 16th Annual Meeting of the International Society for Technology Assessment in Health Care June 20, 2000 in the Hague, Netherlands and at the 21st Annual Meeting of the Society for Medical Decision Making as a poster on October 3, 1999 in Reno, NV.
Background: Studies of schizophrenia treatment often oversimplify the array of health outcomes among patients. Our objective was to derive a set of disease states for schizophrenia using the Positive and Negative Symptom Assessment Scale (PANSS) that captured the heterogeneity of symptom responses.
Methods: Using data from a 1-year clinical trial that collected PANSS scores and costs on schizophrenic patients (
N=663), we conducted a
k-means cluster analyses on PANSS scores for items in five factor domains. Results of the cluster analysis were compared with a conceptual framework of disease states developed by an expert panel. Final disease states were defined by combining our conceptual framework with the empirical results. We tested its utility by examining the influence of disease state on treatment costs and prognosis.
Results: Analyses led to an eight-state framework with varying levels of positive, negative, and cognitive impairment. The extent of hostile/aggressive symptoms and mood disorders correlated with severity of disease states. Direct treatment costs for schizophrenia vary significantly across disease states (
F=27.47,
df=7,
p<0.0001), and disease state at baseline was among the most important predictors of treatment outcomes.
Conclusion: The disease states we describe offer a useful paradigm for understanding the links between symptom profiles and outcomes.</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>15374576</pmid><doi>10.1016/j.schres.2003.11.008</doi><tpages>13</tpages></addata></record> |
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| ispartof | Schizophrenia research, 2004-11, Vol.71 (1), p.83-95 |
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| subjects | Adolescent Adult Adult and adolescent clinical studies Aggression - psychology Biological and medical sciences Cluster Analysis Cognition Disorders - diagnosis Cognition Disorders - epidemiology Female Follow-Up Studies Hostility Humans Male Medical sciences Middle Aged Mood Disorders - diagnosis Mood Disorders - epidemiology Outcome assessment Outcome Assessment (Health Care) Prognosis Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychoses Schizophrenia Schizophrenia - diagnosis Schizophrenia - economics Schizophrenia - epidemiology Severity of Illness Index Treatment costs |
| title | The heterogeneity of schizophrenia in disease states |
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