The Natural History of the Course and Outcome of Schizophrenia

Allardyce, Judith; Os, Jim van

doi:10.1007/978-1-4419-0913-8_3

Cited by 4 publications

(6 citation statements)

References 40 publications

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“…Elevated rates of cognitive deficits have also been observed in first-degree relatives of people with schizophrenia [400][401][402]. As the population-cohort and the conscript studies cited showed, they are measurable already at the prodromal stage [308,309,333,371,403,404]. The birth cohort studies [273,299,301,302,391,394] and the Israeli [311,404,405] and the Swedish [308,309] conscript studies have demonstrated that minor delays in cognitive development and/or deficits in academic attainment and verbal skills are already manifest in childhood and adolescence in individuals later developing schizophrenia.…”

Section: Negative Symptoms and Cognitive Impairmentmentioning

confidence: 99%

“…In a New-Zealand birth cohort study, 25% of the children who, at age 9 to 11 years, had experienced hallucinatory symptoms had a 16-fold excess risk of developing psychotic illness by age 26 years [298]. In the Dutch NEMESIS study, 8% of the adults (aged 18-64 years) who had experienced subclinical hallucinations developed clinical psychosis within two years, which corresponded to an excess risk of about 60% compared with symptom-free controls [161,332,333]. In the German EDSP study, in which probands initially aged 14 to 17 years were assessed four times over a period of 8.4 years, transitions to psychosis depended, in a dose-response relationship, on the persistence of subclinical psychotic symptoms at the follow-up assessments over the first five years: persistence at one measurement was associated with an odds ratio (OR) of 1.5, at two measurements with an OR of 5.0 and at all three measurements with an OR of 9.9 [334].…”

Section: Subclinical Symptoms As Precursors Of Psychosismentioning

confidence: 99%

“…Reasons for this variation are differences in the definitions of good/poor outcome, in the inclusion criteria of the cohorts studied, for example, first admissions versus hospitalized patients in general, and in the lengths of illness [546]. Allardyce & van Os [333] have listed the possible confounders and biases involved.…”

Section: Course and Outcome Of Full-blown Disordermentioning

confidence: 99%

“…Modal values for the overall course of schizophrenia that would be valid worldwide are impossible to calculate due to the heterogeneity of sociocultural environments, due to differences in the proportions of acute, rapidly remitting cases and due to the variation in the quality of the studies on the topic. This has not deterred Allardyce and van Os [333] from estimating good outcome at 42%, intermediate outcome at 35%, and poor outcome at 27% on the basis of a review of 37 studies published between 1966 and 2003 [565].…”

Section: Course and Outcome Of Full-blown Disordermentioning

confidence: 99%

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The Concept of Schizophrenia: From Unity to Diversity

Häfner

2014

Advances in Psychiatry

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After over 100 years of research without clarifying the aetiology of schizophrenia, a look at the current state of knowledge in epidemiology, genetics, precursors, psychopathology, and outcome seems worthwhile. The disease concept, created by Kraepelin and modified by Bleuler, has a varied history. Today, schizophrenia is considered a polygenic disorder with onset in early adulthood, characterized by irregular psychotic episodes and functional impairment, but incident cases occur at all ages with marked differences in symptoms and social outcome. Men’s and women’s lifetime risk is nearly the same. At young age, women fall ill a few years later and less severely than men, men more rarely and less severely later in life. The underlying protective effect of oestrogen is antagonized by genetic load. The illness course is heterogeneous and depressive mood the most frequent symptom. Depression and schizophrenia are functionally associated, and affective and nonaffective psychoses do not split neatly. Most social consequences occur at the prodromal stage. Neither schizophrenia as such nor its main symptom dimensions regularly show pronounced deterioration over time. Schizophrenia is neither a residual state of a neurodevelopmental disorder nor a progressing neurodegenerative process. It reflects multifactorial CNS instability, which leads to cognitive deficits and symptom exacerbations.

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Section: Negative Symptoms and Cognitive Impairmentmentioning

confidence: 99%

Section: Subclinical Symptoms As Precursors Of Psychosismentioning

confidence: 99%

Section: Course and Outcome Of Full-blown Disordermentioning

confidence: 99%

Section: Course and Outcome Of Full-blown Disordermentioning

confidence: 99%

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The Concept of Schizophrenia: From Unity to Diversity

Häfner

2014

Advances in Psychiatry

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“…Schizophrenia usually results in at least one inpatient stay and a high probability of readmission (Allardyce and Os, 2010). Fourteen per cent of the 220,000 people living with schizophrenia in England receive inpatient care each year, including 5% who are compulsorily admitted under the Mental Health Act (Schizophrenia Commission, 2012).…”

Section: Contextmentioning

confidence: 99%

Remote Care for Caregivers of People With Psychosis: Mixed Methods Pilot Study

Romm¹,

Nilsen²,

Gjermundsen³

et al. 2020

JMIR Ment Health

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Background A reduced availability of resources has hampered the implementation of family work in psychosis. Web-based support programs have the potential to increase access to high-quality, standardized resources. This pilot study tested the Norwegian version of the Relatives Education and Coping Toolkit (REACT), a web-based United Kingdom National Health Service program in combination with phone-based support by trained family therapists. Objective We investigated how the program was perceived by its users and identified the facilitators and barriers to its clinical implementation. Methods Relatives of people with psychosis were offered access to REACT and to weekly family therapist support (with 1 of 2 trained family therapists) for 26 weeks. Level of distress and level of expressed emotion data were collected at baseline and after 26 weeks using the Family Questionnaire and the Relatives Stress Scale. Both family therapists and a subset of the relatives were interviewed about their experiences after completing the program. Results During the program, relatives (n=19) had a median of 8 (range 4-11) consultations with the family therapists. Postintervention, there was a significant reduction in stress and in expressed emotions in the relatives of people with psychosis. Interviews with the relatives (n=7) and the family therapists (n=2) indicated the following themes as important—the intervention turned knowledge into action; the intervention strengthened the feeling of being involved and taken seriously by the health services; and management support and the ability for self-referral were important, while lack of reimbursement and clinician resistance to technology were barriers to implementation. Conclusions The service was found to offer a valued clinical benefit; however, strategies that aim to engage clinicians and increase organizational support toward new technology need to be developed.

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Does the Age of Onset Shape the Clinical Picture, Course and Consequences of Schizophrenia? Results from a Long-Term Epidemiological Study

Häfner

2018

Age of Onset of Mental Disorders

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The Natural History of the Course and Outcome of Schizophrenia

Cited by 4 publications

References 40 publications

The Concept of Schizophrenia: From Unity to Diversity

The Concept of Schizophrenia: From Unity to Diversity

Remote Care for Caregivers of People With Psychosis: Mixed Methods Pilot Study

Does the Age of Onset Shape the Clinical Picture, Course and Consequences of Schizophrenia? Results from a Long-Term Epidemiological Study

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