Predictors of Treatment-Resistant and Clozapine-resistant Schizophrenia

A 12-Year Follow-up Study of First-Episode Schizophrenia-Spectrum Disorders

Sherry Kit Wa Chan; Hei Yan Veronica Chan; William G. Honer; Tarun Bastiampillai; Yi Nam Suen; Wai Song Yeung; Ming Lam; Wing King Lee; Roger Man King Ng; Christy Lai Ming Hui; Wing Chung Chang; Edwin Ho Ming Lee; Eric Yu Hai Chen


Schizophr Bull. 2021;47(2):485-494. 

In This Article


Validity and inter-rater reliability

Three trained researchers participated in consensus meetings with the chief clinical researcher every two weeks to ensure consistency of documentation from case note reviews. Research assistants reviewed video recordings of face-to-face interviews of 11 patients and rated clinical symptoms and functioning assessments using the PANSS and SOFAS. The inter-rater reliability for the measurements was assessed to measure the reliability of ratings of each research assistant. Results of the reliability analysis (PANSS: ICC=0.88; SOFAS: ICC=0.87) indicated good inter-rater reliability.

The early intervention services (EIS)

The early intervention service (EIS) in Hong Kong, the Early Assessment Service for Young People with Psychosis (EASY), was established in 2001 as a region-wide service by the public health service provider, the Hong Kong Health Authority (Tang et al 2010). The service has four teams and each consisted of two psychiatrists, three case managers and 0.25 clinical psychologist and served a population of around 1.5 million. The service provided clinical and case management service to patients with first-episode psychosis of age 15–25 for 2 years. Following two years of the EIS, patients would be gradually transit to general public psychiatric service in the third year. The EIS was also closely collaborate with the Non-government service to provide community service for functional improvement.

The standard care service (SCS)

The standard care service (SCS) consisted mainly publicly funded outpatient clinic consultation and inpatient care. It has high service volume with brief clinician consultation (5–6 min per consultation) (Hui et al 2008). Community support including need-based service of community psychiatric nurse, clinical psychologists and social workers. Only about 6% of the discharged in-patients were followed up by a community support service (Tang et al 2010).


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