Recovery from psychotic illness: a 15- and 25-year international follow-up study

Br J Psychiatry. 2001 Jun:178:506-17. doi: 10.1192/bjp.178.6.506.

Abstract

Background: Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.

Aims: To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.

Methods: Historic prospective study. Standardised assessments of course and outcome.

Results: About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.

Conclusions: A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.

Publication types

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

MeSH terms

  • Adult
  • Cross-Cultural Comparison
  • Cross-Sectional Studies
  • Employment
  • Female
  • Follow-Up Studies
  • Humans
  • International Cooperation
  • Male
  • Middle Aged
  • Patient Dropouts / statistics & numerical data
  • Prognosis
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / rehabilitation*
  • Schizophrenia / diagnosis
  • Schizophrenia / rehabilitation
  • Survival Rate
  • Treatment Outcome