November 1979

Long-term Outcome of Major PsychosesI. Schizophrenia and Affective Disorders Compared With Psychiatrically Symptom-Free Surgical Conditions

Author Affiliations

From the Departments of Psychiatry (Dr Tsuang and Mr Fleming) and Preventive Medicine and Environmental Health (Drs Tsuang and Woolson), University of Iowa College of Medicine, Iowa City. Dr Tsuang is on sabbatical until August 1980, at the Department of Psychiatry, University of Oxford, England, where he is a visiting professor as a Josiah Macy Jr Foundation Faculty Scholar; and Dr Woolson is currently a Fellow of the Foundations Fund for Research in Psychiatry, Department of Biomathematics, University of Oxford, England.

Arch Gen Psychiatry. 1979;36(12):1295-1301. doi:10.1001/archpsyc.1979.01780120025002

• We conducted a 30- to 40-year field follow-up of 685 patients with schizophrenia, affective disorders, and nonpsychiatric conditions. Long-term outcome was analyzed in terms of the patients' marital, residential, occupational, and psychiatric status. On the whole, psychiatric patients showed a significantly poorer outcome than the surgical controls. On the basis of long-term outcome, schizophrenia, and affective disorders, selected according to the specified research criteria, were significantly different: schizophrenia definitely showed poorer outcome than affective disorders. However, no significant differences in all four outcome variables were found between mania and depression. We hope that the present data on long-term outcome of the typical cases can be used to compare outcome of other psychiatric disorders, such as undiagnosed psychoses, having mixtures of schizophrenic and affective features. In doing this, we hope to clarify our understanding of undiagnosed psychoses and their relationship to schizophrenia and affective disorders.