The natural course of schizophrenia: a review of first-admission studies.
In this article, research on the natural course of illness among first-admission schizophrenic patients is reviewed from an epidemiological perspective. Three types of studies are considered: statistical reports dating primarily from the preneuroleptic era; long-term followback studies; and more recent prospectively designed cohort studies. Although relatively more first-admission patients have a positive course than do multiple admissions patients, the findings confirm the substantial heterogeneity in course and outcome. Methodological improvements in first-admission research are suggested, including separating the analyses of first-episode patients from those with past psychotic experiences; employing longitudinal methods for deriving diagnosis; including patients with drug and alcohol problems where appropriate; enlarging the samples either by multisite or multicenter collaborations or by pooling data across studies; and obtaining better data on treatment experiences in naturalistic research.
Ram
R
R
Dept. of Psychiatry and Behavioral Science, State University of New York, Stony Brook 11794-8790.
Bromet
E J
EJ
Eaton
W W
WW
Pato
C
C
Schwartz
J E
JE
D005260:Female; D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D012559:Schizophrenia / Q000453:epidemiology*; D012565:Schizophrenic Psychology