title: Long-term course and outcome in schizophrenia: a 34-year follow-up study in Alberta, Canada.
abstract: BACKGROUND
  The aim of this study was to extend an earlier retrospective cohort study of schizophrenia via a prospective study to a follow-up of 34 years, with an emphasis on describing the life-course of the illness.
  
  
  METHODS
  Subjects were 128 first-ever admissions for schizophrenia in 1963 to either of two mental hospital in Alberta, Canada. Follow-up continued until death or 1997. A symptom severity scale, with scores ranging from 0 (no symptoms) to 3 (hospitalized), was used to collect time-series data on each subject and create life-course curves. Indices were constructed to summarize the information in each curve. Information on social functioning was also collected.
  
  
  RESULTS
  Results were similar for men and women. The life-course curves showed marked variability of symptom severity across subjects and over time. The average score over the entire period of follow-up for the cohort indicated 'moderate' symptoms, and the change in average score from beginning to end of follow-up demonstrated a slight worsening of symptoms. The measures of social functioning indicated that only about one quarter of the patients had a good to excellent outcome.
  
  
  CONCLUSIONS
  The long-term course in schizophrenia is one of varying symptom severity, and for many patients, there is a poor overall outcome.
authors.affiliation: Department of Psychiatry, University of Alberta, Edmonton, Canada. stephen.newman@ualberta.ca
authors.forename: S C
authors.initials: SC
authors.lastname: Newman
authors.forename: R C
authors.initials: RC
authors.lastname: Bland
authors.forename: A H
authors.initials: AH
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000416:Alberta; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D017678:Sex Distribution; D012917:Social Adjustment