Prospective follow-up study of 5-year course and outcome in schizophrenia

Background: Although many studies have investigated course and outcome in schizophrenia, few have prospectively studied first-admitted patients for an adequate follow-up period. Objective: To provide data on 5-year course and outcome in a sample of first-admitted schizophrenic patients, and to determine whether a DSM-III-R diagnosis (schizophrenia versus others) at first admission has prognostic implications. Methods: 5-year course and outcome of a follow-up sample of 121 schizophrenic patients (according to ICD-9) were examined with standardized instruments. Results: At 5-year follow-up, half of the sample showed poor outcome in terms of negative symptoms (49%), social disability (51%), social contacts (61%) and employment (51%). Very few patients (20%) showed a continuously favorable course, 42% showed a unstable and 38% a chronic course. Those meeting narrow DSM-III-R criteria had significantly poorer outcomes. Conclusions: The results indicate that during the early course, schizophrenia patients still show relatively poor outcomes.