Remission in schizophrenia: A community-based 6-year follow-up study in Bali

Aim: The purpose of this naturalistic study was to investigate the rate and predictors of remission at medium-term follow up of individuals with schizophrenia in a community setting in Bali. Methods: Subjects comprised 37 individuals with schizophrenia, including 19 never-treated cases, screened from 8546 general residents. Outcome was evaluated using the standardized symptomatic remission criteria based on Positive and Negative Syndrome Scale scores and operational functional remission criteria at 6-year follow up. Results: Ten individuals (27%) achieved symptomatic remission, 12 (32%) achieved functional remission, and 10 (27%) achieved complete remission (i.e. symptomatic and functional remission). Lower Positive and Negative Syndrome Scale negative symptom score at baseline and receipt of psychiatric treatment for more than half of the follow-up period were predictors of complete remission. Conclusions: The majority of community-screened individuals with schizophrenia failed to achieve complete remission at the 6-year follow up. These results suggest that strategies promoting mental health service utilization among individuals with schizophrenia are essential in Bali.