Predicting long‐term outcome in schizophrenia

Abstract

Prediction of 14- to 17-year outcome from symptoms present at admission and psychological and personality data was attempted among the 92 survivors of a group of 110 first-admitted schizophrenic patients. Three different outcome criteria were used and the correlations between these varied from low to high. Using a discriminant analytical approach where all 107 predictor variables were used to predict a combination of outcome criteria, 23% of outcome variance could be explained, which should be compared with 49% in a previous 5- to 9-year outcome study on the same material. At least one outcome variable--economic self-support--could not at all be predicted. "Atypical" symptoms were associated with favourable outcome and longitudinal variables indicative of "high-risk personality", or duration and severity of illness, were related to bad prognosis. Overt psychotic symptoms had no significant correlation with outcome.

Sex differences in schizophrenia and other psychotic disorders: a 20-year longitudinal study of psychosis and recovery

“…However, even when age of onset is addressed by assessing a uniformly young sample, and when there is no sex difference in patients' level of premorbid developmental achievements, women show a better course of illness. Our 20-year followup data do not support the hypothesis advanced by some that outcome of women with schizophrenia declines throughout the course, and eventually approximates that of men with schizophrenia (22)(23)(24), although further research, using even longer followup periods, would be desirable.…”

“…However, in other studies, no sex differences have been found in negative, affective, and psychotic symptoms (17)(18)(19), neurocognitive functioning, MRI findings (20), and number and duration of hospitalizations (21). Some studies suggest that the outcome of women with schizophrenia declines over time, and eventually approximates that of men with schizophrenia (22)(23)(24).…”

Early Antipsychotic Response Predictors in Schizophrenia: A Naturalistic Study

“…However, other studies failed to find any association between outcome and the above-mentioned factors [7,13], making their clinical usefulness very poor. The reasons for these discrepancies could be numerous: firstly, the sample selections are quite different among studies, varying from very strictly criteria to observational studies; secondly, several clinical variables that could modify the antipsychotic response are often not properly take into account or not adequately assessed (e.g.…”

“…On the other hand, predictors of poor outcome include a family history of schizophrenia [8], poor premorbid functioning [6,9,10], lack of insight [6,9], severe negative symptoms [4], a long duration of untreated psychosis [11] and substance misuse [12]. Nonetheless, the prognostic value of these variables remains unclear since several studies failed to find any association between outcome and the above-mentioned factors [7,13].…”

“…Predictors of a better outcome include female gender [4,5], being married at the onset of the illness [5,6], later onset, acute onset [5], and the presence of a psychological stressors preceding the onset [7]. On the other hand, predictors of poor outcome include a family history of schizophrenia [8], poor premorbid functioning [6,9,10], lack of insight [6,9], severe negative symptoms [4], a long duration of untreated psychosis [11] and substance misuse [12].…”