Mortality and long-term course in schizophrenia with a poor 2-year course: a study in a developing country.
BACKGROUND
The short-term course of schizophrenia is reported to be better in some developing country settings. The long-term course in such settings, however, has rarely been studied.


OBJECTIVE
To examine the long-term course and mortality of schizophrenia in patients with a poor 2-year course.


METHODS
The report is based on two incidence cohorts of first-contact patients in urban and rural Chandigarh, India, originally recruited for the World Health Organization Determinants of Outcome of Severe Mental Disorders study. Patients were assessed using standardised instruments at 2- and 15-year follow-ups.


RESULTS
Ninety-two per cent of the patients with a poor 2-year course had a poor long-term course and 47% died - a nine times higher mortality rate than among patients with other 2-year course types.


CONCLUSIONS
In this developing country setting, a poor 2-year course was strongly predictive of poor prognosis and high mortality, raising questions about the adequacy of care for such patients.
Mojtabai
R
R
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA. rm322@columbia.edu
Varma
V K
VK
Malhotra
S
S
Mattoo
S K
SK
Misra
A K
AK
Wig
N N
NN
Susser
E
E
D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors; D014504:Urban Health / Q000706:statistics & numerical data