Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T02:58:32.218Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angermeyer, M. C., Kuhn, L. & Goldstein, J. (1990) Gender and the course of schizophrenia: differences in treated outcomes. Schizophrenia Bulletin, 16, 293–307.CrossRefGoogle ScholarPubMed
Bleuler, M. (1978) The Schizophrenic Disorders: Long-Term Patient and Family Studies (trans. Clemens, S. M.). New Haven: Yale University Press.Google Scholar
Breier, A., Schreiber, J. L., Dyer, J., et al (1991) National Institute of Mental Health Longitudinal Study of Chronic Schizophrenia. Prognosis and predictors of outcome. Archives of General Psychiatry, 48, 239–246.CrossRefGoogle ScholarPubMed
Ciompi, L. (1980) Catamnestic long-term study on the course of life and aging of schizophrenics. Schizophrenia Bulletin, 6, 606–618.Google Scholar
De Jong, A., Giel, R., Slooff, C. J., et al (1985) Social disability and outcome in schizophrenic patients. British Journal of Psychiatry, 147, 631–636.CrossRefGoogle ScholarPubMed
Eaton, W. W., Mortensen, P. B., Herrman, H., et al (1992a) Long-term course of hospitalization for schizophrenia: Part 1. Risk for rehospitalization. Schizophrenia Bulletin, 18, 217–228.CrossRefGoogle Scholar
Eaton, W. W., Bilker, W., Haro, J. M., et al (1992b) Long-term course of hospitalization for schizophrenia: Part 11. Change with passage of time. Schizophrenia Bulletin, 18, 229–241.CrossRefGoogle Scholar
Eaton, W. W., Thara, R., Federman, B., et al (1995) Structure and course of positive and negative symptoms in schizophrenia. Archives of General Psychiatry, 52, 127–134.Google Scholar
Engelhardt, D. M., Rosen, B., Feldman, J., et al (1982) A 15-year follow-up of 646 schizophrenic outpatients. Schizophrenia Bulletin, 8, 493–503.Google Scholar
Harding, C. M. (1988) Course types in schizophrenia: an analysis of European and American studies. Schizophrenia Bulletin, 14, 633–643.CrossRefGoogle ScholarPubMed
Harding, C. M., Brooks, G. W., Ashikaga, T., et al (1987a) The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later. American Journal of Psychiatry, 144, 718–726.Google Scholar
Harding, C. M., Brooks, G. W., Ashikaga, T., et al (1987b) The Vermont longitudinal study of persons with severe mental illness, II: Long-term outcome of subjects who retrospectively met DSM–III criteria for schizophrenia. American Journal of Psychiatry, 144, 727–734.Google ScholarPubMed
Harrison, G. & Mason, P. (1993) Schizophrenia – falling incidence and better outcome? British Journal of Psychiatry, 163, 535–541.Google Scholar
Harrison, G., Croudace, T., Mason, P., et al (1996) Predicting the long-term outcome in schizophrenia. Psychological Medicine, 26, 697–705.Google Scholar
Harrow, M., Yonan, C. A., Sands, J. R., et al (1994) Depression in schizophrenia: are neuroleptics, akinesia, or anhedonia involved? Schizophrenia Bulletin, 28, 327–338.CrossRefGoogle Scholar
Huber, G., Gross, G., Schuttler, R., et al (1980) Longitudinal studies of schizophrenic patients. Schizophrenia Bulletin, 6, 592–605.Google Scholar
Jablensky, A., Schwarz, R. & Tomov, T. (1980) WHO collaborative study on impairments and disabilities associated with schizophrenic disorders. Acta Psychiatrica Scanainavica, 62 (suppl. 285), 152–163.Google Scholar
Jablensky, A., Sartorius, N., Ernberg, E., et al (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization Ten-Country Study. Psychological Medicine, Monograph Supplement 20. Cambridge: Cambridge University Press.Google Scholar
Mason, P., Harrison, G., Glazebrook, C., et al (1995) Characteristics of outcome in schizophrenia at 13 years. British Journal of Psychiatry, 167, 596–603.CrossRefGoogle Scholar
McGlashan, T. H. (1988) A selective review of recent North American long-term follow-up studies of schizophrenia. Schizophrenia Bulletin, 14, 515–543.Google Scholar
Mueser, K. T., Yarnold, P. R., Levinson, D. F., et al (1990) Prevalence of substance abuse in schizophrenia: demographic and clinical correlates. Schizophrenia Bulletin, 16, 31–56.Google Scholar
Schubart, C., Krumm, B., Biehl, H., et al (1986) Measurement of social disability in a schizophrenic patient group. Social Psychiatry, 21, 1–9.Google Scholar
Shepherd, M., Watt, D., Falloon, I., et al (1989) The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. Psychological Medicine, Monograph Supplement 15. Cambridge: Cambridge University Press.Google Scholar
Weissman, M. M. (1977) Controlled vs. naturalistic experiments: application of the life table method. In The Origins and Course of Psychopathology (eds Strauss, J. S., Babigan, H. M. & Roff, M.), pp. 7–21. New York: Plenum Press.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge and London: Cambridge University Press.Google Scholar
World Health Organization (1978) Psychiatric and Personal History Schedule. Geneva: World Health Organization.Google Scholar
World Health Organization (1992) Life Chart Schedule. Geneva: World Health Organization.Google Scholar
World Health Organization (1992) Substance Abuse Schedule. Geneva: World Health Organization.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.