1. Recovery from psychotic illness: A 15- and 25-year international follow-up study
- Author
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C. Skoda, P.W.H. Lee, Dermot Walsh, W. an der Heiden, Durk Wiersma, S.J. Tsirkin, C. Leon, K. C. Dube, Kim Hopper, Glynn Harrison, C Siegel, Eugene M. Laska, S. Malhotra, Anthony J. Marsella, Yucun Shen, V. Varma, Joseph Wanderling, Y. Nakane, R. Giel, Norman Sartorius, K. Ganev, Aleksandar Janca, S.K. Holmberg, R. Thara, and Tom K. J. Craig
- Subjects
Adult ,Cross-Cultural Comparison ,Employment ,Male ,COUNTRIES ,Gerontology ,Patient Dropouts ,PREDICTION ,DISORDERS ,Cross-sectional study ,International Cooperation ,03 medical and health sciences ,0302 clinical medicine ,SCHIZOPHRENIA ,Humans ,Medicine ,COHORT ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Psychiatric Status Rating Scales ,business.industry ,Clinical study design ,Incidence (epidemiology) ,SEVERE MENTAL-ILLNESS ,Social environment ,Middle Aged ,Prognosis ,medicine.disease ,030227 psychiatry ,Survival Rate ,Psychiatry and Mental health ,Cross-Sectional Studies ,Treatment Outcome ,Psychotic Disorders ,Schizophrenia ,Cohort ,Female ,business ,Follow-Up Studies ,Cohort study ,Demography - Abstract
BackgroundPoorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.AimsTo describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.MethodHistoric prospective study. Standardised assessments of course and outcome.ResultsAbout 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.ConclusionsA significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.
- Published
- 2001