A sample of 502 schizophrenic patients, who had been admitted to the University Psychiatric Clinic between 1945 and 1959, was systematically followed up between 1967 and 1973. The same well-defined diagnostic criteria were used throughout the study. At the time of the last followup, the average duration of illness was 22.4 years. Twenty-two percent of the patients showed complete psychopathological remissions, 43% had noncharacteristic types of remission, and 35 percent suffered from characteristic schizophrenic deficiency syndromes. Psychopathological outcome in the patients studied was assessed in relationship to such factors as duration of illness, social remission, family history of schizophrenia, primary personality, educational level, social class, age at onset, and presence of precipitating factors. It is concluded that prognostic predictions are possible only when several factors with a similar influence on long-term outcome occur in combination and when factors with a contrary prognostic influence are absent. Even under these circumstances, the individual course is by no means certain. The hypothesis that presenting symptomatology can be used to differentiate between true schizophrenias and schizophreniform psychoses is not supported.
A systematic psychiatric follow-up study of 502 schizophrenics was carried out using the same well-defined criteria to evaluate the patients throughout the investigation. After an average course of disease of 22.4 years, 22.1% of the patients showed complete psychopathological remission, 43.2% had non-characteristic types of remission and 34.7% suffered from characteristic schizophrenic deficiency syndromes. At the time of the last follow-up investigation, 86.7% of the patients were living at home, while 13.3% were permanently hospitalized. Of the entire sample, 55.9% were found to be "socially recovered". Higher education, psychoreactive provocation, depressive traits, perception of delusions, catatonic agitation, non-characteristic thought disorders and symptoms of depersonalization at the onset of the illness tended to carry with them a favorable prognosis. On the other hand, low intelligence, abnormal primary personality, premorbid disturbances in social behavior, broken homes, prolonged prodromal stages, pneumoence-phalographically measurable atrophic or dysplastic changes in the brain ventricles as well as somatic and auditory hallucinations and predominance of hebephrenic symptoms at the onset of the illness tended to lead to an unfavorable prognosis. The principle of the basic reversibility of typical schizophrenic symptoms and the extensive irreversibility of the non-characteristic defect is important for the psychopathological and social long-term prognosis.
The aim of the present study was to investigate the potential predictive value of early self-experienced neuropsychological deficits for the subsequent development of schizophrenia. A total of 96 patients with DSM-III-R diagnoses of personality disorders (formerly called 'neurotic disorders') who had been examined for the presence of such subjective experiences of deficits with standardized instruments were re-examined for the possible development of schizophrenic symptoms. After an average follow-up period of about 8 years, more than 50% of the patients had developed schizophrenia according to DSM-III-R criteria. In 77% of cases the outcome 'schizophrenia vs. no schizophrenia' was correctly predicted by the earlier presence or absence of self-experienced disturbances of thought, speech, memory, perception and action. These findings suggest that certain self-experienced neuropsychological deficits are able to indicate susceptibility to psychosis.
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