Predictors of outcome in first-episode schizophrenia over the first 4 years of illness.
BACKGROUND
The outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.


METHODS
We conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.


RESULTS
There were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=-3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=-2.77, p<0.01) significantly predicted a better outcome at follow-up.


CONCLUSIONS
The outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.
Whitty
P
P
Adelaide and Meath Hospital, Tallaght, Dublin, Ireland.
Clarke
M
M
McTigue
O
O
Browne
S
S
Kamali
M
M
Kinsella
A
A
Larkin
C
C
O'Callaghan
E
E
D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome