© 1998 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Natural Course of Schizophrenic Disorders: A 15-Year Followup of a Dutch Incidence Cohort
Sociologist Department of Social Psychiatry, WHO Collaborating Center, University of Groningen Groningen, The Netherlands
Psychologist Department of Social Psychiatry, WHO Collaborating Center, University of Groningen Groningen, The Netherlands
Psychiatrist Department of Social Psychiatry, WHO Collaborating Center, University of Groningen Groningen, The Netherlands
Psychiatrist Department of Social Psychiatry, WHO Collaborating Center, University of Groningen Groningen, The Netherlands
Reprint requests should be sent to Dr. D. Wiersma, Dept. of Social Psychiatry, WHO Collaborating Ctr., University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
Data are presented on the 15-year natural course of schizophrenia and other nonaffective functional psychoses in a cohort of 82 first-contact cases from a circumscribed area in the Netherlands. The subjects were suffering from functional psychosis with International Classification of Diseases-Ninth Revision (ICD-9) diagnoses 295, 297, or 298.3–9 (broad definition of schizophrenia) on entry. Standardized assessments of psychopathology, psychological impairments, negative symptomatology, social disability, and use of mental healthcare were used. The study reveals a pattern of chronicity and relapses with a high risk of suicide: Two-thirds of the subjects had at least one relapse and after each relapse 1 of 6 subjects did not remit from the episode; 1 of 10 committed suicide; and 1 of 7 had at least one episode with affective psychotic symptoms that started on average 6 years after the onset of the schizophrenic disorder. Diagnoses were reclassified in five patients, according to DSM-III-R criteria for a bipolar disorder. The predictive power—in terms of time in psychosis and in partial or full remission—of demographic, illness, and treatment variables at onset of the illness was very limited. Insidious onset and delays in mental health treatment are risk factors that predict a longer duration of first or subsequent episodes. The importance of mental health treatment in regard to outcome is probably subject to change because an early warning and intervention strategy could prevent further damage and deterioration. Our data support the need for an adequate relapse prevention program as a priority for our mental health services.
Keywords: Course / prediction / relapse
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Alvarez-Jimenez, A. G. Parker, S. E. Hetrick, P. D. McGorry, and J. F. Gleeson Preventing the Second Episode: A Systematic Review and Meta-analysis of Psychosocial and Pharmacological Trials in First-Episode psychosis Schizophr Bull, November 9, 2009; (2009) sbp129v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. I. Velligan, M. Draper, D. Stutes, N. Maples, J. Mintz, S. Tai, and D. Turkington Multimodal Cognitive Therapy: Combining Treatments That Bypass Cognitive Deficits and Deal With Reasoning and Appraisal Biases Schizophr Bull, September 1, 2009; 35(5): 884 - 893. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Crumlish, P. Whitty, M. Clarke, S. Browne, M. Kamali, M. Gervin, O. McTigue, A. Kinsella, J. L Waddington, C. Larkin, et al. Beyond the critical period: longitudinal study of 8-year outcome in first-episode non-affective psychosis The British Journal of Psychiatry, January 1, 2009; 194(1): 18 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Singh Outcome measures in early psychosis: Relevance of duration of untreated psychosis The British Journal of Psychiatry, August 1, 2007; 191(50): s58 - s63. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Wade, S. Harrigan, J. Edwards, P. M. Burgess, G. Whelan, and P. D. McGorry Substance misuse in first-episode psychosis: 15-month prospective follow-up study The British Journal of Psychiatry, September 1, 2006; 189(3): 229 - 234. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Clarke, P. Whitty, S. Browne, O. McTigue, M. Kamali, M. Gervin, A. Kinsella, J. L. Waddington, C. Larkin, and E. O'Callaghan Untreated illness and outcome of psychosis The British Journal of Psychiatry, September 1, 2006; 189(3): 235 - 240. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. GARETY, T. K. J. CRAIG, G. DUNN, M. FORNELLS-AMBROJO, S. COLBERT, N. RAHAMAN, J. READ, and P. POWER Specialised care for early psychosis: symptoms, social functioning and patient satisfaction: Randomised controlled trial The British Journal of Psychiatry, January 1, 2006; 188(1): 37 - 45. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M.G. NORMAN, S. W. LEWIS, and M. MARSHALL Duration of untreated psychosis and its relationship to clinical outcome The British Journal of Psychiatry, August 1, 2005; 187(48): s19 - s23. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. PETERSEN, M. NORDENTOFT, P. JEPPESEN, J. OHLENSCHLAeGER, A. THORUP, T. O. CHRISTENSEN, G. KRARUP, J. DAHLSTROM, B. HAASTRUP, and P. JORGENSEN Improving 1-year outcome in first-episode psychosis: OPUS trial The British Journal of Psychiatry, August 1, 2005; 187(48): s98 - s103. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Which atypical antipsychotic for schizophrenia? DTB, August 1, 2004; 42(8): 57 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Perkins, J. Lieberman, H. Gu, M. Tohen, J. McEvoy, A. Green, R. Zipursky, S. Strakowski, T. Sharma, R. Kahn, et al. Predictors of antipsychotic treatment response in patients with first-episode schizophrenia, schizoaffective and schizophreniform disorders The British Journal of Psychiatry, July 1, 2004; 185(1): 18 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Lauriello, J. R. Bustillo, and K. C. Shingler The First Interview of a Patient with Psychosis: Symptoms, Safety, and Stabilization Focus, January 1, 2004; 2(1): 7 - 12. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. RUGGERI, A. LASALVIA, M. TANSELLA, C. BONETTO, M. ABATE, G. THORNICROFT, L. ALLEVI, and P. OGNIBENE Heterogeneity of outcomes in schizophrenia: 3-year follow-up of treated prevalent cases The British Journal of Psychiatry, January 1, 2004; 184(1): 48 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. ANDREWS, K. SANDERSON, J. CORRY, C. ISSAKIDIS, and H. LAPSLEY Cost-effectiveness of current and optimal treatment for schizophrenia The British Journal of Psychiatry, November 1, 2003; 183(5): 427 - 435. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. G. Siris Suicide and schizophrenia J Psychopharmacol, March 1, 2001; 15(2): 127 - 135. [Abstract] [PDF]
|
|