One-year outcome and its prediction in first-episode schizophrenia--a naturalistic study.
BACKGROUND
The literature suggests that the early course of schizophrenia is a strong predictor of long-term outcome. We sought to test this notion in a sample of first-episode patients.


METHODS
Forty patients with a first episode of DSM-IV diagnoses of schizophrenia, schizoaffective, or schizophreniform disorder were assessed with well-established instruments such as the Positive and Negative Syndrome Scale and the Strauss-Carpenter Scale. Reassessment was performed 14 months later and included the Global Assessment of Functioning Scale in addition to the aforementioned instruments and a psychiatric interview. Regression analyses for the Global Assessment of Functioning Scale and symptomatology were used to identify outcome predictors.


RESULTS
At follow-up, 27 patients (67.5%) were in remission. Women's outcome was significantly better with respect to intimate relationships and domiciliary independence. Although symptomatology of the whole group remained stable during the follow-up period, a subgroup of patients experienced a significant decrease in symptom levels whereas symptoms increased in another subgroup. The most important predictor of outcome was compliance with atypical antipsychotic medication during the follow-up period.


CONCLUSIONS
These results suggest that there is a prognostic divide early in the course of the disease, that compliance with medication is of overriding importance towards 1-year outcome, and that for the individual patient the question of chronicity may be answered very early in the course of the disease.
Bachmann
Silke
S
Department of Psychiatry and Psychotherapy, University of Halle, Halle, Germany. silke.bachmann@medizin.uni-halle.de
Bottmer
Christina
C
Schroder
Johannes
J
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012074:Remission Induction; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D014150:Antipsychotic Agents