David Baxter PhD
Late Founder
Schizophrenia outcomes 'not as poor as previously assumed'
By Liam Davenport
14 July 2008
Psychol Med 2008; 38: 1141-1146
The outcome of schizophrenia can be relatively favorable, and most patients do not experience a deteriorating course of illness, say Irish researchers.
The majority of research into the course and outcome of schizophrenia has focused on non-first-episode patients who have experienced multiple hospital admissions and chronic disease. However, recent investigations have indicated that outcome may not be as negative as previously thought.
Noting the methodologic issues that have limited the validity of outcome studies, E O'Callaghan, from University College Dublin, and colleagues followed-up 97 patients with first-episode schizophrenia for the first 4 years of illness.
The patients were assessed using the Structured Clinical Interview, the Positive and Negative Syndrome Scale (PANSS), the Strauss-Carpenter Scale, and the Global Assessment of Functioning (GAF). In addition, the duration of untreated psychosis (DUP) was determined.
At first presentation, the average age of psychosis onset was 25.5 years and the DUP was 20.1 months. The average length of follow-up was 42.0 months, during which time the average number of admissions was 2.6 and each patient spent an average of 92.8 days in hospital.
During follow-up, the patients experienced significant improvements in positive and negative PANSS scores, reducing from 22.3 to 10.3 and from 17.2 to 14.3, respectively, as well as significant improvements in GAF scores, from 22.4 to 58.7. In addition, there was a substantial reduction in the number of unemployed patients, from 40% to 21%.
Significant predictors at first presentation of better outcome at follow-up were found to be fewer negative symptoms, more years spent in education, and a shorter DUP, at t values of -3.40, 3.25, and -2.77, respectively.
"This study supports the view that the outcome of schizophrenia is not as poor as was once thought," the team writes in the journal Psychological Medicine.
"Patients with schizophrenia show significant morbidity at first presentation in terms of psychopathology and GAF. However, unlike earlier descriptions of a downward deteriorating course and poor outcome, the subjects in this study evidenced significant improvements at follow-up in terms of psychopathology and GAF."
Abstract
By Liam Davenport
14 July 2008
Psychol Med 2008; 38: 1141-1146
The outcome of schizophrenia can be relatively favorable, and most patients do not experience a deteriorating course of illness, say Irish researchers.
The majority of research into the course and outcome of schizophrenia has focused on non-first-episode patients who have experienced multiple hospital admissions and chronic disease. However, recent investigations have indicated that outcome may not be as negative as previously thought.
Noting the methodologic issues that have limited the validity of outcome studies, E O'Callaghan, from University College Dublin, and colleagues followed-up 97 patients with first-episode schizophrenia for the first 4 years of illness.
The patients were assessed using the Structured Clinical Interview, the Positive and Negative Syndrome Scale (PANSS), the Strauss-Carpenter Scale, and the Global Assessment of Functioning (GAF). In addition, the duration of untreated psychosis (DUP) was determined.
At first presentation, the average age of psychosis onset was 25.5 years and the DUP was 20.1 months. The average length of follow-up was 42.0 months, during which time the average number of admissions was 2.6 and each patient spent an average of 92.8 days in hospital.
During follow-up, the patients experienced significant improvements in positive and negative PANSS scores, reducing from 22.3 to 10.3 and from 17.2 to 14.3, respectively, as well as significant improvements in GAF scores, from 22.4 to 58.7. In addition, there was a substantial reduction in the number of unemployed patients, from 40% to 21%.
Significant predictors at first presentation of better outcome at follow-up were found to be fewer negative symptoms, more years spent in education, and a shorter DUP, at t values of -3.40, 3.25, and -2.77, respectively.
"This study supports the view that the outcome of schizophrenia is not as poor as was once thought," the team writes in the journal Psychological Medicine.
"Patients with schizophrenia show significant morbidity at first presentation in terms of psychopathology and GAF. However, unlike earlier descriptions of a downward deteriorating course and poor outcome, the subjects in this study evidenced significant improvements at follow-up in terms of psychopathology and GAF."
Abstract
