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March 1991

Posthospital Course and Outcome in Schizophrenia

Author Affiliations

From the Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School (Dr Carone); and the Departments of Psychiatry, Michael Reese Hospital and Medical Center and University of Illinois College of Medicine, (Drs Harrow and Westermeyer), Chicago, Ill.

Arch Gen Psychiatry. 1991;48(3):247-253. doi:10.1001/archpsyc.1991.01810270059008

• To study the early course of schizophrenia, we assessed 79 early phase, young, DSM-III schizophrenic patients at two successive posthospital follow-ups, 2.5 and 5.0 years after index hospitalization. More than 50% of the sample had poor overall outcome, with either severe impairment in functioning and symptoms, or suicide, in the follow-up period. Rehospitalization rates decreased significantly during the course of the two posthospital assessments, despite the sample showing persisting psychosis. Only a small group of schizophrenic patients showed complete remission: 10% at the first follow-up and 17% at the second follow-up, when patients who suicided are excluded from consideration. While progressive deterioration is not common in schizophrenia, our relatively negative findings challenge the conclusions of some other longitudinal studies. Implications of our data on schizophrenic course are discussed.

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