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June 1984

The Chestnut Lodge Follow-up Study: II. Long-term Outcome of Schizophrenia and the Affective Disorders

Author Affiliations

From the Chestnut Lodge Research Institute, Rockville, Md.

Arch Gen Psychiatry. 1984;41(6):586-601. doi:10.1001/archpsyc.1984.01790170060007

• This report details the long-term course for systematically rediagnosed (and largely chronically ill) patients with schizophrenia (n =163) and with bipolar (n =19) and unipolar (n = 44) affective disorders from the Chestnut Lodge, Rockville, Md, follow-up study. Their conditions were assessed and they are described rigorously from multiple outcome perspectives. Except in the realm of symptomatic diathesis, striking differences emerged between these major axis I disorders consonant with Kraepelin's original observations. Roughly two thirds of the schizophrenic patients were functioning marginally or worse at follow-up, compared with one third of the unipolar cohort. The reverse held for better outcomes. Outcome varied little as a function of follow-up interval (time) across all diagnostic categories. Representative case examples serve to place the ratings in meaningful clinical contexts.

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