The psychosis of schizophrenia: Prevalence, response to atypical antipsychotics, and prediction of outcome

Alan Breier, Paul H. Berg

Research output: Contribution to journalArticle

47 Scopus citations


Background: Psychosis is a defining feature of schizophrenia consisting of formal thought disorder, delusions, and hallucinations. Although psychosis is present in the majority of patients with schizophrenia, the prevalence, responsiveness to atypical antipsychotic drug therapy, and prediction of outcome of individual psychotic symptoms in a population of well-diagnosed patients with schizophrenia have not been conclusively established. Methods: This paper examined the prevalence, responsiveness to the atypical antipsychotic olanzapine, and relationship to outcome of individual psychotic symptoms using data from a previously reported large multicenter, double-blind clinical trial of olanzapine (mean daily dose at endpoint = 13.6 ± 6.9 mg/day). Results: The most frequently reported psychotic symptoms at baseline were delusions (65%), conceptual disorganization (50%), and hallucinations (52%), and the majority of patients (68%) experienced from one to three symptoms. Additionally, with olanzapine treatment there were significant improvements (p < .001) in baseline to endpoint Positive and Negative Symptom Scale (PANSS) psychotic item scores, with the largest effect sizes observed for hallucinatory behavior, unusual thought content, suspiciousness/persecution, and delusions. During the acute phase of the trial, quality of life was correlated significantly with baseline conceptual disorganization (p = .038) and unusual thought content (p = .023), and time spent in the hospital was correlated with unusual thought content (p = .005). Conclusions: The implications of these for the clinical management of schizophrenia are discussed. Copyright (C) 1999 Society of Biological Psychiatry.

Original languageEnglish (US)
Pages (from-to)361-364
Number of pages4
JournalBiological psychiatry
Issue number3
StatePublished - Aug 1 1999


  • Atypical antipsychotic
  • Olanzapine
  • Psychosis
  • Schizophrenia

ASJC Scopus subject areas

  • Biological Psychiatry

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