title: The course of schizophrenia: progressive deterioration, amelioration or both?
abstract: BACKGROUND
  Schizophrenia may follow a course of amelioration, deterioration or stability. It is possible that deterioration at the aggregate level may be due to a sub-group of patients with a tendency to deteriorate.
  
  
  OBJECTIVE
  To examine the course of schizophrenia in a national population-based cohort.
  
  
  METHODS
  All first admissions for schizophrenia in Israel 1978-1986 were followed for readmissions in the Israeli psychiatric hospitalization registry for 10 years (n=6865). Readmission rates were examined using cluster analysis. This was followed by an examination of changes in readmission patterns.
  
  
  RESULTS
  Cluster analysis identified a small cluster of patients who spent more days in the hospital over time and two clusters that improved. A priori classification of the patients into deteriorating, improving and stable (based on days hospitalized per year) revealed that approximately 75% of patients improved over time.
  
  
  CONCLUSIONS
  Over time a majority of patients appear to improve and a minority appear to deteriorate.
authors.affiliation: Bar Ilan University, Ramat Gan, Israel. jr827@columbia.edu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rabinowitz
authors.forename: Stephen Z
authors.initials: SZ
authors.lastname: Levine
authors.forename: Rachel
authors.initials: R
authors.lastname: Haim
authors.forename: Heinz
authors.initials: H
authors.lastname: Häfner
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D015995:Prevalence; D012042:Registries; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index