Heterogeneity of outcomes in schizophrenia. 3-year follow-up of treated prevalent cases.
BACKGROUND
Care for people with schizophrenia should address a wide range of outcomes, including professional and consumer perspectives.


OBJECTIVE
To measure changes in psychopathology, functioning, needs for care and quality of life; to develop predictive models for each outcome domain; and to assess the frequency of 'good'and'poor' outcomes, as defined in a series of different definitions that use combinations of the four domains measured.


METHODS
Three-year follow-up of a 1-year-treated prevalence cohort of 107 patients with an ICD-10 diagnosis of schizophrenia attending the South Verona community-based mental health service.


RESULTS
Mean symptom severity and some types of needs for care worsen, but quality of life shows no change. Functioning shows a non-significant trend to deteriorate. Between 32% and 42% of the variance in the four key outcomes was explained by our model. Different definitions of 'good'and 'poor' outcome included 0-31% of patients, depending on the definition used.


CONCLUSIONS
The 3-year outcome for schizophrenia depends on the domain of outcome used, whether staff or patient ratings are used and the stringency of the definitions used for good and poor outcome.
Ruggeri
Mirella
M
Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy. mirella.ruggeri@univr.it
Lasalvia
Antonio
A
Tansella
Michele
M
Bonetto
Chiara
C
Abate
Maria
M
Thornicroft
Graham
G
Allevi
Liliana
L
Ognibene
Paola
P
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012559:Schizophrenia / Q000534:rehabilitation / Q000628:therapy*; D012565:Schizophrenic Psychology; D013223:Statistics as Topic; D016896:Treatment Outcome