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Prognosis in Schizophrenia: Prognostic Predictors and Outcome

Prognosis in Schizophrenia: Prognostic Predictors and Outcome Abstract • 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 firstadmission 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. References 1. Eitinger L, Laane CL, Langfeldt G: The prognostic value of the clinical picture and the therapeutic value of physical treatment in schizophrenia and schizophreniform states . Acta Psychiatr Scand 33:33-53, 1958.Crossref 2. Stephens JH, Astrup C: Prognosis in "process" and "non-process" schizophrenia . Am J Psychiatry 119:945-952, 1963. 3. Stephens JH, Astrup C, Mangrum JC: Prognostic factors in recovered and deteriorated schizophrenics . Am J Psychiatry 122:1116-1121, 1966. 4. Vaillant GE: The prediction of recovery in schizophrenia . J Nerv Ment Dis 135:534-543, 1962.Crossref 5. Vaillant GE: Prospective prediction of schizophrenic remission . Arch Gen Psychiatry 11:509-518, 1964.Crossref 6. Robins E, Guze SB: Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia . Am J Psychiatry 126:983-987, 1970. 7. Brown GW, Bone M, Dalison B, et al: Schizophrenia and Social Care . London, Oxford University Press, 1966, pp 136-149. 8. Schwartz CC, Myers JK, Astrachan BM: Concordance of multiple assessments of the outcome of schizophrenia . Arch Gen Psychiatry 32:1221-1227, 1975.Crossref 9. Strauss JD, Carpenter WT: The prediction of outcome in schizophrenia: I. Characteristics of outcome . Arch Gen Psychiatry 27:739-746, 1972.Crossref 10. Astrup C, Noreik K: Functional Psychoses: Diagnostic and Prognostic Models . Springfield, Ill, Charles C Thomas Publisher, 1966, pp 13-17. 11. Strauss JS, Carpenter WT: Characteristic symptoms and outcome in schizophrenia . Arch Gen Psychiatry 30:429-434, 1974.Crossref 12. Hawk AB, Carpenter WT, Strauss JS: Diagnostic criteria and five year outcome in schizophrenia . Arch Gen Psychiatry 32:343-347, 1975.Crossref 13. Report of the International Pilot Study of Schizophrenia . Geneva, World Health Organization, 1973, vol 1. 14. Feighner JP, Robins E, Guze SB, et al: Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 26:57-63, 1972.Crossref 15. Bland RC, Parker JH, Orn H: Prognosis in schizophrenia: A ten-year follow-up of first admissions . Arch Gen Psychiatry 33:949-954, 1976.Crossref 16. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria (RDC) . New York, Biometrics Research, 1975. 17. Strauss JS Carpenter WT: The prediction of outcome in schizophrenia: II. Relationships between predictor and outcome variables . Arch Gen Psychiatry 31:37-42, 1974.Crossref 18. Statistical Review of England and Wales for 1960. London, Her Majesty's Stationery Office, 1964. 19. Helgason T: Epidemiology of mental disorders in Iceland . Acta Psychiatr Scand 40( (suppl 173) ):67-95, 1964. 20. Larsson T, Sjögren T: A methodological psychiatric and statistical study of a large Swedish rural population . Acta Psychiatr Neurol Scand , (suppl 80) , 1954, pp 1-250. 21. Yolles SF, Kramer M: Vital statistics , in Bellak L, Loeb L (eds): The Schizophrenic Syndrome . New York, Grune & Stratton Inc, 1969, pp 66-113. 22. Taylor MA: Schneiderian first-rank symptoms and clinical prognostic features in schizophrenia . Arch Gen Psychiatry 26:64-67, 1972.Crossref 23. Wing JK: Five-year outcome in early schizophrenia . Proc R Soc Med 59:17-18, 1966. 24. Raman AC, Murphy HBM: Failure of traditional prognostic indicators in Afro-Asian psychotics: Results of a long term follow up study . J Nerv Ment Dis 154:238-247, 1972.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Prognosis in Schizophrenia: Prognostic Predictors and Outcome

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1978.01770250074007
Publisher site
See Article on Publisher Site

Abstract

Abstract • 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 firstadmission 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. References 1. Eitinger L, Laane CL, Langfeldt G: The prognostic value of the clinical picture and the therapeutic value of physical treatment in schizophrenia and schizophreniform states . Acta Psychiatr Scand 33:33-53, 1958.Crossref 2. Stephens JH, Astrup C: Prognosis in "process" and "non-process" schizophrenia . Am J Psychiatry 119:945-952, 1963. 3. Stephens JH, Astrup C, Mangrum JC: Prognostic factors in recovered and deteriorated schizophrenics . Am J Psychiatry 122:1116-1121, 1966. 4. Vaillant GE: The prediction of recovery in schizophrenia . J Nerv Ment Dis 135:534-543, 1962.Crossref 5. Vaillant GE: Prospective prediction of schizophrenic remission . Arch Gen Psychiatry 11:509-518, 1964.Crossref 6. Robins E, Guze SB: Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia . Am J Psychiatry 126:983-987, 1970. 7. Brown GW, Bone M, Dalison B, et al: Schizophrenia and Social Care . London, Oxford University Press, 1966, pp 136-149. 8. Schwartz CC, Myers JK, Astrachan BM: Concordance of multiple assessments of the outcome of schizophrenia . Arch Gen Psychiatry 32:1221-1227, 1975.Crossref 9. Strauss JD, Carpenter WT: The prediction of outcome in schizophrenia: I. Characteristics of outcome . Arch Gen Psychiatry 27:739-746, 1972.Crossref 10. Astrup C, Noreik K: Functional Psychoses: Diagnostic and Prognostic Models . Springfield, Ill, Charles C Thomas Publisher, 1966, pp 13-17. 11. Strauss JS, Carpenter WT: Characteristic symptoms and outcome in schizophrenia . Arch Gen Psychiatry 30:429-434, 1974.Crossref 12. Hawk AB, Carpenter WT, Strauss JS: Diagnostic criteria and five year outcome in schizophrenia . Arch Gen Psychiatry 32:343-347, 1975.Crossref 13. Report of the International Pilot Study of Schizophrenia . Geneva, World Health Organization, 1973, vol 1. 14. Feighner JP, Robins E, Guze SB, et al: Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 26:57-63, 1972.Crossref 15. Bland RC, Parker JH, Orn H: Prognosis in schizophrenia: A ten-year follow-up of first admissions . Arch Gen Psychiatry 33:949-954, 1976.Crossref 16. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria (RDC) . New York, Biometrics Research, 1975. 17. Strauss JS Carpenter WT: The prediction of outcome in schizophrenia: II. Relationships between predictor and outcome variables . Arch Gen Psychiatry 31:37-42, 1974.Crossref 18. Statistical Review of England and Wales for 1960. London, Her Majesty's Stationery Office, 1964. 19. Helgason T: Epidemiology of mental disorders in Iceland . Acta Psychiatr Scand 40( (suppl 173) ):67-95, 1964. 20. Larsson T, Sjögren T: A methodological psychiatric and statistical study of a large Swedish rural population . Acta Psychiatr Neurol Scand , (suppl 80) , 1954, pp 1-250. 21. Yolles SF, Kramer M: Vital statistics , in Bellak L, Loeb L (eds): The Schizophrenic Syndrome . New York, Grune & Stratton Inc, 1969, pp 66-113. 22. Taylor MA: Schneiderian first-rank symptoms and clinical prognostic features in schizophrenia . Arch Gen Psychiatry 26:64-67, 1972.Crossref 23. Wing JK: Five-year outcome in early schizophrenia . Proc R Soc Med 59:17-18, 1966. 24. Raman AC, Murphy HBM: Failure of traditional prognostic indicators in Afro-Asian psychotics: Results of a long term follow up study . J Nerv Ment Dis 154:238-247, 1972.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jan 1, 1978

References

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