Outcome of schizophrenia: the Madras longitudinal study.
OBJECTIVE
The aim of the study was to determine the clinical outcome in a group of first-episode schizophrenic patients on a 10-year follow-up. The social, demographic and clinical variables associated with poor outcome and gender differences in outcome were other issues addressed.


METHODS
Ninety patients fulfilling Feighner's and ICD-9 criteria for schizophrenia, at Madras, India, were included for a 10-year follow-up. The Present State Examination and the Psychiatric and Personal schedule were administered at intake and at the end of every year. Clinical outcome was considered as a combination of the pattern of course and the presence of positive symptoms during year 10.


RESULTS
After 10 years, 76 of the 90 patients included were followed up, giving a follow-up rate of 84%. The clinical outcome was good in nearly 75% of the patients with almost all symptoms showing a steep decline at the end of 10 years. Fifty-nine subjects were asymptomatic at the end of the follow-up period and 12 were ill during the entire 10th year. Sexual, religious and grandiose delusions and flat affect at inclusion predicted a poor clinical outcome. More males had a poor outcome and spent a longer time in a psychotic state.


CONCLUSIONS
There is evidence of a good outcome in the majority of first-episode schizophrenic patients after 10 years in keeping with other reports from developing countries. Certain variables at inclusion predicted a poor clinical outcome and males had a poorer outcome than females.
Schizophrenia Research Foundation, East Anna Nagar, Madras, India.
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D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003906:Developing Countries; D006801:Humans; D007194:India; D008137:Longitudinal Studies; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome