A 20‐year follow‐up study on schizophrenia in Singapore

Kua, Joshua; Wong, KokSheik; Kua, Ee Heok; Tsoi, W F

doi:10.1034/j.1600-0447.2003.00107.x

Cited by 51 publications

(41 citation statements)

References 31 publications

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“…Our sample and that of Wiersma et al 18 (20.4%) in the Netherlands showed one of the smallest proportions of subjects with some form of employment at study end (25.6%). In contrast, Kua et al 26 reported that 88% were employed in Singapore and emphasised the importance of work in their culture. Higher unemployment rates in the general population (for example, compared with the province of Alberta whose economy was stronger with less unemployment than Quebec) 5 could also be hypothesized, along with a more generous unemployment benefits program in Canada, which does not encourage people with partial invalidity to get a job.…”

Section: Is Outcome Really Negative?mentioning

confidence: 96%

“…30 Different outcome dimensions show more stability after 5 years of evolution, replicating data in other studies from different decades. 19,26,31,32 As discussed by Harrison et al,19 this raises the hypothesis of a critical window for therapeutic interventions, as the early psychosis intervention movement now purports.…”

Section: Course Of Illness and Interventionsmentioning

confidence: 99%

“…Hopper and Wanderling 20 reported that diagnostic criteria had a significant impact on the percentage of recovered subjects. In the recent Kua et al study, 26 60% had an illness of less than 6 months duration at admission; it remains unclear how many of these subjects would not meet DSM-III-R schizophrenia criteria.…”

Section: Is Outcome Really Negative?mentioning

confidence: 99%

“…10 For data on all subjects, we accessed the following provincial databases and information from January 1, 1983, to May 31, 1999: Med-Echo (Logibec, Montreal, QC) (longitudinal datafiles of hospital admissions in Quebec) and Fichier de l'hygiène mentale du Canada for the dates and duration of all psychiatric hospitalizations as well as deaths across Quebec; Institut de la statistique du Québec for the dates and causes of death; and RAMQ (physician billing agency) for all medical consultations, including care by psychiatrists or general practitioners, and the region where people lived at admission, during the follow-up period, and in 1999. Helgason 27 Kua et al 26 Mason et al 21,22 an der Heiden et al 37 Wiersma et al 23 Wiersma et al 18 Harisson et al 19 Hopper Twenty-five percent of subjects were lost to follow-up for the whole sample, including the prevalence sample and non-schizophrenic psychosis. The proportion of lost to follow-up for the incidence schizophrenia sample is not specified.…”

Section: Data Collectionmentioning

confidence: 99%

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Schizophrenia, An Illness with Bad Outcome: Myth or Reality?

et al. 2011

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Objective: Different myths about schizophrenia endorsed by clinicians maintain the pessimism about outcome thus reducing chances of improvement. There are no recent North American studies on the long-term outcome of first-episode schizophrenia to clarify if these beliefs are myths or reality. Our study describes the long-term outcome (10 to 16 years) of a first-episode schizophrenia incidence cohort (n = 142) in a Canadian urban centre between 1983 and 1999.Method: Clinical and social functioning at different time points were assessed retrospectively from medical files of a catchment area hospital in Montreal. Service use and deaths were noted from provincial databases of physician billings, hospitalization, and vital statistics.Results: Hospitalization days decreased considerably after the first year, with a small minority still needing it episodically after 4 years. Marital and occupational status were generally stable over time, but autonomy in living arrangements worsened. Thirty-three percent of subjects quit the Catchment Area Specialized Psychiatric Services. This group showed better social functioning while they were followed, were hospitalized less afterwards, and had fewer suicides, therefore indicating a better outcome for them. At the end of our study, 15% of the patients still alive were well enough to function without seeking medical help and 25% were not taking antipsychotic medication. Better outcome was predicted by older age at admission, being married, higher premorbid autonomy in living arrangements, and female sex. Conclusion:A significant proportion of first-episode schizophrenia patients achieve moderate long-term outcome, and the stability of global functioning is more frequent than deterioration, as shown in most industrialized countries.Can J Psychiatry. 2011;56(2):92-101. Clinical Implications• The heterogeneity of outcome widens as duration of follow-up increases, and a proportion of schizophrenia patients might function without long-term medication.• Occupational deficit stability suggests it should be the target of early intervention programs to prevent significant deterioration of functioning and of later supported employment rehabilitation approaches.• The decline in autonomous housing suggests early supported housing in the community, in collaboration with relatives, when patients move from their parents' home. Limitations• Our sample covered most of the catchment-area incident schizophrenia patients, but was limited to patients hospitalized at least once.• The functioning of a proportion of subjects could not be assessed until study end, but many of them were functioning without seeking medical help.• No symptomatology measures were included, therefore no correlations could be made between symptoms and functioning.

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Section: Is Outcome Really Negative?mentioning

confidence: 96%

Section: Course Of Illness and Interventionsmentioning

confidence: 99%

Section: Is Outcome Really Negative?mentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

See 2 more Smart Citations

Schizophrenia, An Illness with Bad Outcome: Myth or Reality?

et al. 2011

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“…La esquizofrenia también se asocia a un riesgo elevado de suicidio y el Standard Mortality Rate por suicidio varía entre el 15,7 15 y el 39,7 16 . El porcentaje de sujetos con diagnóstico de esquizofrenia que cometen suicidio a lo largo de su vida también varía notablemente, desde el 4,9 17 al 9,7% según distintos estudios 18 .…”

Section: Introductionunclassified