BACKGROUND: Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. AIMS: To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables. METHODS: Historic prospective study. Standardised assessments of course and outcome. RESULTS: About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery. CONCLUSIONS: A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.
BACKGROUND: Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. AIMS: To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables. METHODS: Historic prospective study. Standardised assessments of course and outcome. RESULTS: About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery. CONCLUSIONS: A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.
Authors: Neeraj Tandon; Debra Montrose; Jai Shah; R P Rajarethinam; Vaibhav A Diwadkar; Matcheri S Keshavan Journal: J Psychiatr Res Date: 2011-11-04 Impact factor: 4.791
Authors: Helen Lester; Nagina Khan; Peter Jones; Max Marshall; David Fowler; Tim Amos; Max Birchwood Journal: Br J Gen Pract Date: 2012-03 Impact factor: 5.386
Authors: W Wolfgang Fleischhacker; Celso Arango; Paul Arteel; Thomas R E Barnes; William Carpenter; Ken Duckworth; Silvana Galderisi; Lisa Halpern; Martin Knapp; Stephen R Marder; Mary Moller; Norman Sartorius; Peter Woodruff Journal: Schizophr Bull Date: 2014-04 Impact factor: 9.306
Authors: Stephanie Salcedo; Sabeen H Rizvi; Lindsey K Freeman; Jennifer K Youngstrom; Robert L Findling; Eric A Youngstrom Journal: Eur Child Adolesc Psychiatry Date: 2018-03-20 Impact factor: 4.785