Medium-term course and outcome of schizophrenia depicted by the sixth-month subtype after an acute episode.
OBJECTIVE
The intermediate course of schizophrenia is a complex intertwined with the heterogeneity of the illness. This article attempts to simplify this complexity using a hypothetical tripartite based on the profile of symptoms at 6 months after acute treatment.


METHODS
This is a prospective 5-year follow-up study including 163 schizophrenic inpatients in northern Taiwan comparing patients' demographic data at index admission, scores on the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and social function scale measured at admission, 6-month follow-up, and annually, and scores on a neuropsychologic test battery measured approximately 5 years after recruitment.


RESULTS
Patients were grouped into three subtypes based on their sixth-month symptomatology by Generalized Association Plots, designated as remitted (RM), persistent delusion/hallucination (PDH), and markedly blunting (MB) groups. These three subtypes presented with similar positive symptom profiles at recruitment, yet during follow-up, the PDH group tended to maintain the highest risk of having worse clinical symptomatology, social functioning, and neuropsychologic functioning, and the RM was the best outcome group.


CONCLUSIONS
This three-subtype model provides a practical reference to predict medium-term outcomes by the subject's response to acute treatment and serves as a model to sort out part of the heterogeneous nature of schizophrenia that still should be examined by further psychopharmacological, neurobiological, and genetic studies.
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Chen-Chung
CC
Liu
Chun-Houh
CH
Chen
Hai-Gwo
HG
Hwu
Shang-Ying
SY
Shiu
Mau-Sun
MS
Hua
Chen-Hsin
CH
Chen
Tzung-Jeng
TJ
Hwang
Chih-Min
CM
Liu
Ming H
MH
Hsieh
Shi-Kai
SK
Liu
Wei J
WJ
Chen
D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index