Cross-national clinical and functional remission rates: Worldwide Schizophrenia Outpatient Health Outcomes (W-SOHO) study

Background Evidence suggests that schizophrenia may have a better outcome for individuals living in low- and middle-income countries compared with affluent settings. Aims To determine the frequency of symptom and functional remission in out-patients with schizophrenia in different regions of the world. Method Using data from the Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO) study we measured clinical and functional remission in out-patients with schizophrenia in different regions of the world, and examined sociodemographic and clinical factors associated with these outcomes. The 11 078 participants analysed from 37 participating countries were grouped into 6 regions: South Europe, North Europe, Central and Eastern Europe, Latin America, North Africa and Middle East, and East Asia. Results In total, 66.1% achieved clinical remission during the 3-year follow-up (range: 60.1% in North Europe to 84.4% in East Asia) and 25.4% achieved functional remission (range: 17.8% in North Africa and Middle East to 35.0% in North Europe). Regional differences were not explained by participants' clinical characteristics. Baseline social functioning, being female and previously untreated were consistent predictors of remission across regions. Conclusions Clinical outcomes of schizophrenia seem to be worse in Europe compared with other regions. However, functional remission follows a different pattern.