Clinical and psychosocial variables in different diagnostic groups: their interrelationships and value as predictors of course and outcome during a 14-year follow-up.

A 14-year follow-up study was conducted on 214 patients from the diagnostic groups schizophrenia, affective psychosis, and neurosis to determine the relationships between various clinical and psychosocial variables and to assess their value as predictors of long-term course and outcome. Particular emphasis was placed on ascertaining the interrelationships between the variables within the individual diagnostic groups. The results indicate that for schizophrenia, severity of disease at discharge from index hospitalization was the principal predictor of the number and duration of further hospitalizations. Furthermore, it predicted the severity of illness and social functioning at follow-up. For affective psychosis, the Global Assessment Scale score predicted the number and duration of further hospitalizations. Severity of illness, social functioning, and age at first hospitalization were predictors of occupational development. For neurotic disorders, severity of disease and social adjustment at discharge from index hospitalization were each predictors of themselves at final follow-up. In addition, age at first hospitalization was an important predictor of most course and psychosocial variables. Among the endogenous course variables within the schizophrenic group, the number and duration of further hospitalizations had a substantial bearing on severity of illness and social functioning at follow-up. For affective psychoses, indicators of occupational development and number of hospitalizations had an impact on severity of illness and social functioning at follow-up. Our findings reveal a good overall predictive value for the clinical and psychosocial variables within each of the diagnostic categories studied.