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Schizophrenia Bulletin 1999 25(2):337-348;
© 1999 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

Outcome of Schizophrenia in Relation to Brain Abnormalities

Wouter G. Staal, M.D., Hilleke E. Hulshoff Pol, Ph.D. and René S. Kahn, M.D., Ph.D.
Research Fellow in Psychiatry, University Hospital Utrecht Utrecht, The Netherlands
Assistant Professor of Psychiatry, University Hospital Utrecht Utrecht, The Netherlands
Professor of Psychiatry and Chairman of the Department of Psychiatry, University Hospital Utrecht Utrecht, The Netherlands

Reprint requests should be sent to Dr. W.G. Staal, Department of Psychiatry, University Hospital Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands, fax 0031-30-2505443

This article reviews the 21 studies that investigated possible relationships between structural brain abnormalities and outcome in schizophrenia. Fifteen studies used computer tomography to visualize brain morphology. In these studies, images were obtained of the ventricles but not of specific brain regions. The remaining six studies used magnetic resonance imaging, examining possible relationships between outcome, ventricular size, and specific brain regions. One out of two studies found relationships between brain structure and outcome. The data suggest that the extent of ventricular enlargement in patients with schizophrenia may be related to outcome. No clear relationship between outcome and changes in specific brain regions was found. Apart from considerations about the methodology of measuring different brain regions, the procedure used to measure outcome is important. Outcome, as it is assessed at various points during the course of illness, may be variable and seems to fluctuate during the first 10 to 15 years of disease. Significantly, to date no studies relating outcome to brain structure have used patient samples with a duration of illness longer than 15 years.

Keywords: Outcome / course / neuroimaging


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