Schizophrenia Bulletin Advance Access originally published online on December 18, 2007
Schizophrenia Bulletin 2008 34(2):245-246; doi:10.1093/schbul/sbm125
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© The Author 2007. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.
Is Prognosis in the Individual, the Environment, the Disease, or What?
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This wonderful title was suggested by Will Carpenter. It provides a perfect context for considering the problem of prognosis in general, and more specifically, the report by Cohen et al. on the question of cultural differences in prognosis.
Often unrecognized currently, prognosis has for centuries been one of the foundations of scientific medicine. Hippocrates, Sydenham, and in psychiatry, Kraepelin, utilized prognosis as the basis for identifying disease processes. This contrasted strongly with the tendency to use the clinical picture or "syndrome" at one moment in time as the basis for defining various diseases. In fact, Kraepelin put together 3 very different syndromes, considering them one disease (dementia praecox) because of what he believed to be their common inexorable downhill course. Aside from its use for identifying disease processes, prognosis also serves as a basis against which treatment effectiveness can be measured
1 To whom correspondence should be addressed; e-mail: john.strauss@yale.edu.