Long-term outcome of treated schizophrenia in a Nigerian cohort. Retrospective analysis of 7-year follow-ups.

Consecutive case records of 142 patients (55 males and 87 females) who fulfilled stringent criteria for schizophrenia, and attended the psychiatric facilities at the Ibadan teaching hospital for at least 7 consecutive years were studied in detail in order to determine outcome in a period of follow-up that ranged from 7 to 26 years (mean +/- SD, 13.3 +/- 4.6 years). A unique history of stability of staff and research record keeping, as well as the fact that relatives frequently accompany patients to hospital, enhanced the reliability and validity of documents. Using outcome criteria that included the presence of positive and negative symptoms of schizophrenia and social adjustment in the past 12 months, it was found that 72 (50.7%) patients were in the good outcome group, while 34 (23.9%) and 36 (25.4%) had moderate and poor outcome, respectively. The social and clinical characteristics of the patients were similar to those of participants in World Health Organization prospective studies in this country. Whereas there was a nonsignificant trend for more females to be without psychotic symptoms, the males performed significantly better in social adjustment outcome measures. In contrast with reports from the Western world, patients with acute onset and episodic course were a common feature of the cohort. The results support previous reports indicating fairly good outcome of schizophrenia in developing countries.