title: Recovery from psychotic illness: a 15- and 25-year international follow-up study.
abstract: BACKGROUND
  Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.
  
  
  OBJECTIVE
  To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.
  
  
  METHODS
  Historic prospective study. Standardised assessments of course and outcome.
  
  
  RESULTS
  About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.
  
  
  CONCLUSIONS
  A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.
authors.affiliation: Division of Psychiatry, University of Bristol, UK. G.Harrison@bristol.ac.uk
authors.forename: G
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authors.lastname: Harrison
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authors.initials: K
authors.lastname: Hopper
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authors.lastname: Craig
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authors.lastname: Laska
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authors.initials: C
authors.lastname: Siegel
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authors.lastname: Wanderling
authors.forename: K C
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authors.lastname: Dube
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authors.initials: K
authors.lastname: Ganev
authors.forename: R
authors.initials: R
authors.lastname: Giel
authors.forename: W
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authors.lastname: an der Heiden
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authors.lastname: Holmberg
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authors.forename: P W
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authors.lastname: Lee
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authors.initials: CA
authors.lastname: León
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authors.initials: S
authors.lastname: Malhotra
authors.forename: A J
authors.initials: AJ
authors.lastname: Marsella
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authors.lastname: Nakane
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authors.lastname: Sartorius
authors.forename: Y
authors.initials: Y
authors.lastname: Shen
authors.forename: C
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authors.lastname: Skoda
authors.forename: R
authors.initials: R
authors.lastname: Thara
authors.forename: S J
authors.initials: SJ
authors.lastname: Tsirkin
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authors.lastname: Varma
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authors.lastname: Walsh
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authors.lastname: Wiersma
mesh_terms: D000328:Adult; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000534:rehabilitation*; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation; D015996:Survival Rate; D016896:Treatment Outcome