TY - JOUR
T1 - Interrelationships of Changes in Outcome Domains in Patients With Schizophrenia Spectrum Disorders
T2 - A Meta-Analysis
AU - de Winter, Lars
AU - Jelsma, Auke
AU - Vermeulen, Jentien M.
AU - Vellinga, Astrid
AU - van Weeghel, Jaap
AU - Hasson-Ohayon, Ilanit
AU - Mulder, Cornelis L.
AU - Boonstra, Nynke
AU - Veling, Wim
AU - de Haan, Lieuwe
N1 - Publisher Copyright:
© 2025 The Author(s). Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
PY - 2025/7
Y1 - 2025/7
N2 - Introduction: Patients with schizophrenia spectrum disorders (SSD) improve in several outcome domains over the course of illness, but to different degrees. In this meta-analysis, we investigated whether longitudinal changes in different outcome domains are associated with each other and which factors moderate these changes over time. Methods: Our protocol was preregistered in PROSPERO (CRD42024504253). We included 109 studies, identified through searches in PsycInfo, PubMed, CINAHL, and Cochrane up until November 2023, investigating longitudinal changes in at least two outcome domains (symptoms, social functioning, cognition or personal recovery) for patients with SSD with at least 1 year follow-up. We calculated Pearson correlation coefficients for associations of changes between outcome domains. Potential moderating effects of demographic, clinical, social, or study characteristics were explored. Quality assessment was executed using the QUIPS tool. Results: We found substantial positive associations between changes in symptoms, social functioning, and cognition. Especially, changes in negative symptoms and overall social functioning were associated with changes in several outcome domains. Changes in personal recovery were only associated with changes in symptoms. We found more substantial improvements in combinations of outcomes for patients with a shorter illness duration, females, a lower percentage of patients diagnosed with schizophrenia, and patients receiving treatment focused on targeted outcomes. Conclusions: Symptoms, social functioning, and cognition often concurrently improve and may boost each other. This suggests that an integrated approach targeting several outcome domains jointly boosts long-term improvement. However, changes in personal recovery seem to occur separately from other outcome domains. Therefore, targeted attention for personal recovery is needed. Trial Registration: PROSPERO: CRD42024504253.
AB - Introduction: Patients with schizophrenia spectrum disorders (SSD) improve in several outcome domains over the course of illness, but to different degrees. In this meta-analysis, we investigated whether longitudinal changes in different outcome domains are associated with each other and which factors moderate these changes over time. Methods: Our protocol was preregistered in PROSPERO (CRD42024504253). We included 109 studies, identified through searches in PsycInfo, PubMed, CINAHL, and Cochrane up until November 2023, investigating longitudinal changes in at least two outcome domains (symptoms, social functioning, cognition or personal recovery) for patients with SSD with at least 1 year follow-up. We calculated Pearson correlation coefficients for associations of changes between outcome domains. Potential moderating effects of demographic, clinical, social, or study characteristics were explored. Quality assessment was executed using the QUIPS tool. Results: We found substantial positive associations between changes in symptoms, social functioning, and cognition. Especially, changes in negative symptoms and overall social functioning were associated with changes in several outcome domains. Changes in personal recovery were only associated with changes in symptoms. We found more substantial improvements in combinations of outcomes for patients with a shorter illness duration, females, a lower percentage of patients diagnosed with schizophrenia, and patients receiving treatment focused on targeted outcomes. Conclusions: Symptoms, social functioning, and cognition often concurrently improve and may boost each other. This suggests that an integrated approach targeting several outcome domains jointly boosts long-term improvement. However, changes in personal recovery seem to occur separately from other outcome domains. Therefore, targeted attention for personal recovery is needed. Trial Registration: PROSPERO: CRD42024504253.
UR - http://www.scopus.com/inward/record.url?scp=105001366348&partnerID=8YFLogxK
U2 - 10.1111/acps.13808
DO - 10.1111/acps.13808
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C2 - 40159424
AN - SCOPUS:105001366348
SN - 0001-690X
VL - 152
SP - 6
EP - 26
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
IS - 1
ER -
