Self-esteem and Relapse in Schizophrenia A 5-Year Follow-Up Study

This study investigated the association between an interview-based measure of self-esteem and subsequent clinical outcome in recent-onset schizophrenia. A cohort 5-year follow-up design with retrospective chart assessment of clinical outcomes was used. Relapse rates during 5 years were very high, with 92% of the sample relapsing. Self-esteem consisted of two dimensions, negative evaluation of self (NES) and positive evaluation of self (PES). Survival analysis indicated that high NES was significantly associated with shorter time to relapse; and PES, with longer survival time. The participants with high PES were three times more likely to have delayed relapse; no other covariates were significant. PES seemed to buffer the adverse effects of NES. The results indicate that social cognition in the form of self-evaluation may be implicated in clinical outcome and symptom exacerbation in schizophrenia.