title: Long-term follow-up of patients with a diagnosis of paranoid state and hospitalized, 1913 to 1940.
abstract: 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.
authors.affiliation: The Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Stephens
authors.forename: P
authors.initials: P
authors.lastname: Richard
authors.forename: P R
authors.initials: PR
authors.lastname: McHugh
mesh_terms: D000328:Adult; D004565:Electroconvulsive Therapy; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis; D006753:Hospital Records; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007331:Insulin Coma; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010259:Paranoid Disorders / Q000175:diagnosis*; D010433:Pentylenetetrazole / Q000627:therapeutic use; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis; D012563:Schizophrenia, Paranoid / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D013405:Suicide / Q000706:statistics & numerical data
chemical_list: D010433:Pentylenetetrazole