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.
Department of Psychiatry and Psychotherapy, University of Halle, Halle, Germany. silke.bachmann@medizin.uni-halle.de
Silke
S
Bachmann
Christina
C
Bottmer
Johannes
J
Schroder
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