Long-term follow-up of patients with a diagnosis of paranoid state and hospitalized, 1913 to 1940

J Nerv Ment Dis. 2000 Apr;188(4):202-8. doi: 10.1097/00005053-200004000-00002.


From a sample of 239 patients diagnosed paranoid state and hospitalized between 1913 and 1940 at the Phipps Clinic, we particularly studied a group of 60 patients without previous hospitalizations, consisting of 57 patients with follow-ups of 5 or more years, and 3 patients who killed themselves (the ultimate follow-up) less than 1 year after discharge. These 60 patients had been retrospectively diagnosed with delusional disorders by DSM-IV criteria. On follow-up, 27% were rated recovered, whereas 52% were rated unimproved. Long-term follow-up was correlated with discharge status. Poor follow-up was significantly correlated with seclusive personality, poor premorbid history, onset 6 months or more before admission, gradual onset, lack of insight, single marital status, and lack of precipitating events. A prognostic scale constructed from the first four of these variables was predictive of long-term outcome. More recent, better treatment results have been contrasted with these findings from an earlier non-drug-treatment era.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Electroconvulsive Therapy
  • Female
  • Follow-Up Studies
  • Hallucinations / diagnosis
  • Hospital Records
  • Hospitalization*
  • Hospitals, Psychiatric
  • Humans
  • Insulin Coma
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Paranoid Disorders / diagnosis*
  • Pentylenetetrazole / therapeutic use
  • Prognosis
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Retrospective Studies
  • Schizophrenia / diagnosis
  • Schizophrenia, Paranoid / diagnosis*
  • Schizophrenic Psychology
  • Suicide / statistics & numerical data


  • Pentylenetetrazole