Outcome of schizophrenic subtypes defined by four diagnostic systems.
This report examines the short- and long-term outcome of the subtypes of schizophrenia as defined by four diagnostic systems: DSM-III, Research Diagnostic Criteria, Ninth Revision of the International Classification of Diseases, and the Tsuang-Winokur (T-W) criteria. Patients were from the Iowa 500 study and met Washington University criteria for schizophrenia. Subtype diagnosis was based on extensive chart material reviewed by investigators blind to outcome. Short-term outcome, based on chart information, and long-term outcome, based on individual field follow-up, were both better for paranoid than for nonparanoid schizophrenia, the difference being greatest using the T-W criteria. The difference in outcome between paranoid and nonparanoid schizophrenia was greater at long-term than at short-term follow-up, and greater using residential and occupational than psychiatric outcome criteria. Outcome did not differ for the two common forms of nonparanoid schizophrenia: hebephrenic and undifferentiated. The subtyping of schizophrenia has important predictive validity, which was greatest using the T-W criteria.
D004651:Employment; D005500:Follow-Up Studies; D006801:Humans; D008370:Manuals as Topic / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis*; D012562:Schizophrenia, Disorganized / Q000145:classification / Q000175:diagnosis; D012563:Schizophrenia, Paranoid / Q000145:classification / Q000175:diagnosis