Prognosis in schizophrenia. Prognostic predictors and outcome.

Eighty-eight of 92 first-admission schizophrenics from 1963, an incidence by first admission cohort, were followed up in 1974 and 1975. Epidemiologically the sample was more comparable to lower European rates and expectancy rather than to higher American figures. Prior to follow-up, factors said to predict outcome were scored. This prognostic information was complete for 79 cases. Outcome was measured on a variety of criteria. The patients fell into a "poor prognosis" group based on the prognostic indicators, which were of little value in predicting prognosis within this group. However, patients who received extensive service during the follow-up period had poorer outcomes. Outcome was better than in most earlier studies of schizophrenia, but similar to that in some other recent studies of first-admission patients; also, the use of phenothiazines, short-term hospitalization, and community services may play a part. The failure of prognostic indicators to predict more than about 25% of the outcome variance for this group of "poor prognosis" patients supports the viewpoint that "good" and "poor" prognosis schizophrenia are two different entities.