A Sixteen-Year Follow-Up of Schizophrenic Patients Seen in an Outpatient Clinic

Introduction  Dementia precox, as described by Kraepelin, was considered in the very great majority of cases to be an illness whose clinical onset was in the second or third decade of life.¹ Kraepelin emphasized that during adolescence the tendency to psychic disease was quite pronounced. Bleuler agreed that in the majority of patients he studied the symptoms became manifest soon after puberty.² He thought that age of onset per se, however, had little value in establishing a prognosis. This has seemed to be the over-all finding of the many follow-up studies which have been reported since. Bellak,³ reviewing the literature, feels that only those onsets prior to puberty or after the age of 40 are of poorer prognostic significance. Some workers, however, such as Rennie,⁴ talk of a poor prognosis for patients with onset before 21 years of age. Unfortunately, they lump together adolescents and preadolescents