Name: LB-102 in Schizophrenia: Long-term morbidity
Published: 2026-10-08T10:27:28-04:00

Treatment resistance: consensus criteria

“The consensus group identified minimum and optimal criteria, employing the following principles: 1) current symptoms of a minimum duration and severity determined by a standardized rating scale; 2) ≥moderate functional impairment; 3) prior treatment consisting of ≥2 different antipsychotic trials, each for a minimum duration and dose” (opens the source at this quote in a new tab)

“More specifically, the TRRIP Working Group recommended that symptoms be of at least 12 weeks’ duration in total, be of at least moderate severity, and be associated with at least moderate functional impairment as determined by validated rating scales (e.g., PANSS, BPRS, or SANS and SAPS for symptoms and a score < 60 on the SOFAS as a measure of functioning). If a prospective medication trial of at least 6 weeks at adequate dose has not led to symptom reduction of more than 20%, this provides additional evidence of treatment resistance.” (opens the source at this quote in a new tab)

Treatment resistance: proportion of first-episode cohorts

“Twelve studies were included, totalling 11 958 participants; six studies were of high quality. The rate of TRS was 22.8% (95% CI 19.1-27.0%, P < 0.001) among all first-episode cohorts and 24.4% (95% CI 19.5-30.0%, P < 0.001) among first-episode schizophrenia cohorts.” (opens the source at this quote in a new tab)

“Seventy per cent (n = 56) of TR patients, and 23% of the total study population (n = 246) were treatment resistant from illness onset.” (opens the source at this quote in a new tab)

Rehospitalization and readmission

“During follow-up, 13 042 of 29 823 patients (43.7%) were rehospitalized, and 20 225 of 28 189 patients (71.7%) experienced treatment failure.” (opens the source at this quote in a new tab)

“Among patients with an initial hospital stay for schizophrenia, the 30-day readmission rate was over four times higher than for a non-M/SUD condition (15.7 vs. 3.8 percent), when only stays with a principal diagnosis of schizophrenia are counted. When the definition of readmissions was expanded to include stays with schizophrenia as a principal or secondary diagnosis, 18.6 percent of patients experienced a 30-day readmission—115 percent higher than for non-M/SUD stays (8.7 percent).” (opens the source at this quote in a new tab)

Metabolic syndrome: CATIE baseline and meta-analysis

“Of 1460 CATIE baseline subjects, 689 met analysis criteria. MS prevalence was 40.9% and 42.7%, respectively using the NCEP and AHA derived criteria. In females it was 51.6% and 54.2% using the NCEP and AHA criteria, compared to 36.0% (p = .0002) and 36.6% (p = .0003), respectively for males.” (opens the source at this quote in a new tab)
“In a logistic regression model with age, race and ethnicity as covariates, CATIE males were 138% more likely to have MS than the NHANES matched sample, and CATIE females 251% more likely than their NHANES counterparts.” (opens the source at this quote in a new tab)

“The overall rate of MetS was 32.5% (95% CI = 30.1%–35.0%), and there were only minor differences according to the different definitions of MetS, treatment setting (inpatient vs outpatient), by country of origin and no appreciable difference between males and females.” (opens the source at this quote in a new tab)

“The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678).” (opens the source at this quote in a new tab)

Cardiovascular disease in severe mental illness

“The pooled CVD prevalence in SMI patients (mean age 50 years) was 9.9% (95% CI: 7.4‐13.3). Adjusting for a median of seven confounders, patients had significantly higher odds of CVD versus controls in cross‐sectional studies (odds ratio, OR=1.53, 95% CI: 1.27‐1.83; 11 studies), and higher odds of coronary heart disease (OR=1.51, 95% CI: 1.47‐1.55) and cerebrovascular disease (OR=1.42, 95% CI: 1.21‐1.66).” (opens the source at this quote in a new tab)

Tardive dyskinesia prevalence

“The global mean TD prevalence was 25.3% (95% CI = 22.7%-28.1%) across all 41 studies (N = 11,493, mean age = 42.8 years, male = 66.4%, schizophrenia-spectrum disorders = 77.1%). TD prevalence varied greatly: Rates were lower with current SGA treatment (20.7%; 95% CI = 16.6%-25.4%, N = 5,103) vs current FGA treatment (30.0%; 95% CI = 26.4%-33.8%, N = 5,062; Q = 9.17, P = .002).” (opens the source at this quote in a new tab)

Substance use comorbidity

“The prevalence of any SUD was 41.7%, followed by illicit drugs (27.5%), cannabis (26.2%), alcohol (24.3%) and stimulant use (7.3%).” (opens the source at this quote in a new tab)

“Relative to the general population, individuals with severe psychotic disorders have increased risk of smoking (OR 4.6, 95% CI 4.3-4.9), heavy alcohol use (OR 4.0, 95% CI 3.6-4.4), heavy marijuana use (OR 3.5, 95% CI 3.2-3.7), and recreational drug use (OR 4.6, 95% CI 4.3-5.0).” (opens the source at this quote in a new tab)

Tobacco smoking

“Forty-two studies across 20 nations consistently demonstrated an association between schizophrenia and current smoking (weighted average odds ratio, OR=5.9; 95% confidence interval, CI 4.9--5.7).” (opens the source at this quote in a new tab)

“Overall, 64% of individuals with schizophrenia, 44% with bipolar disorder, and 19% without psychiatric illness reported that they were current smokers.” (opens the source at this quote in a new tab)

Employment

“People with SSDs were less likely to be employed (16.9% vs. 61.0%; AOR 0.1, CI=0.1–0.3).” (opens the source at this quote in a new tab)

“Altogether, 14.5% of the patients reported participating in competitive employment in the month before the baseline assessment, 12.6% reported other (noncompetitive) employment activity, and 72.9% reported no employment activity.” (opens the source at this quote in a new tab)

“Most recent European studies report rates between 10 % and 20%, while the rate in the US is less clear.” (opens the source at this quote in a new tab)

“An employment rate of 10.24% and societal costs of USD 890 million (NOK 7.9 billion) was also found for this patient group using comprehensive healthcare and welfare registers.” (opens the source at this quote in a new tab)

Educational attainment and global functioning: United States adults

“Compared to people without SSDs, those with SSDs were more likely to have no more than a high school degree (63.9% vs. 36.3%; AOR 3.5, CI=1.6–7.7) and less likely to have completed college (3.6% vs. 32.2%; AOR 0.1, CI=0.0–0.1).” (opens the source at this quote in a new tab)
“Mean Global Assessment of Functioning scores were lower among people with than without schizophrenia (44.8 [standard error 2.0] vs. 77.2 [0.5], p<0.01).” (opens the source at this quote in a new tab)

Social functioning over 20 years

“Functioning in the preserved group did not differ from that of never psychotic individuals at 20-years, but the other groups functioned worse (all p < 0.001). Differences among trajectories were already evident in childhood.” (opens the source at this quote in a new tab)

Homelessness

“The study included 10,340 persons treated for schizophrenia, bipolar disorder, or major depression in the San Diego County Adult Mental Health Services over a 1-year period (1999-2000).” (opens the source at this quote in a new tab)
“The prevalence of homelessness was 15%. Homelessness was associated with male gender, African American ethnicity, presence of a substance use disorder, lack of Medicaid, a diagnosis of schizophrenia or bipolar disorder, and poorer functioning.” (opens the source at this quote in a new tab)

“Thirty-one studies involving 51,925 homeless people were included in the final analysis.” (opens the source at this quote in a new tab)
“The meta-analysis showed a remarkably higher prevalence of psychosis [21.21% (95% CI:13.73, 31.29), I2 = 99.43%], schizophrenia [10.29% (95%, CI: 6.44, 16.02), I2 = 98.76%]” (opens the source at this quote in a new tab)

Incarceration

“During the year, 11.5% of patients (N=4,544) were incarcerated. Risk factors for incarceration included prior incarcerations; co-occurring substance-related diagnoses; homelessness; schizophrenia, bipolar, or other psychotic disorder diagnoses; male gender; no Medicaid insurance; and being African American.” (opens the source at this quote in a new tab)

“Forty-seven respondents (9%) were incarcerated over the follow-up period.” (opens the source at this quote in a new tab)

“We identified 109 samples including 33 588 prisoners in 24 countries. Data were meta-analysed using random-effects models, and we found a pooled prevalence of psychosis of 3.6% (95% CI 3.1-4.2) in male prisoners and 3.9% (95% CI 2.7-5.0) in female prisoners.” (opens the source at this quote in a new tab)

Violence and comorbid substance abuse

“We identified 20 individual studies reporting data from 18,423 individuals with schizophrenia and other psychoses.” (opens the source at this quote in a new tab)
“The effect of comorbid substance abuse was marked with the random-effects ORs of 2.1 (95% confidence interval [CI] 1.7–2.7) without comorbidity, and an OR of 8.9 (95% CI 5.4–14.7) with comorbidity” (opens the source at this quote in a new tab)