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The Course of Schizophrenia Over 13 Years

A Report from the International Study on Schizophrenia (ISoS) Coordinated by the World Health Organization

Published online by Cambridge University Press:  02 January 2018

Peter Mason ,
Glynn Harrison ,
Cristine Glazebrook ,
Ian Medley  and
Tim Croudace
Peter Mason*
Affiliation:
Department of Psychiatry, University Hospital, Nottingham NG7 2UH
Glynn Harrison
Affiliation:
Department of Psychiatry, University Hospital, Nottingham NG7 2UH
Cristine Glazebrook
Affiliation:
Department of Psychiatry, University Hospital, Nottingham NG7 2UH
Ian Medley
Affiliation:
Department of Psychiatry, University Hospital, Nottingham NG7 2UH
Tim Croudace
Affiliation:
Mandala Centre, Nottingham NG7 6LB
*
Dr Mason, Department of Psychiatry, Royal Liverpool University Hospital, Liverpool, L69 3BX
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Abstract

Background

This paper describes the 13 year course of illness in an epidemiologically defined and representative cohort of patients selected when they were experiencing their first episode of schizophrenia.

Method

In a 13-year follow-up study of 67 patients with ICD–9 schizophrenia, identified in Nottingham in 1978–80, the course of illness (symptoms, disability and hospitalisation) was assessed using standardised instruments, applied at onset 1, 2, and 13 years. Time to first relapse and first readmission were calculated and plotted as survival curves and patients were assigned to the course types described by Ciompi.

Results

The survival curves show that first relapses and first readmissions occur during the first five years. The amount of time spent in psychotic episodes and in hospital is greatest in the first year of follow-up, but stable thereafter. Social adjustment improves from entry to the study to the first follow-up year, but there is a small deterioration in social adjustment between 2 and 13 years.

Conclusions

The findings reported suggest that after the initial episode the course of schizophrenia is relatively stable. The data support neither concepts of progressive deterioration nor progressive amelioration. There was no evidence of a ‘late recovery’.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 5 , November 1996 , pp. 580 - 586
Copyright
Copyright © Royal College of Psychiatrists, 1996 

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