title: Onset Pattern and Long-Term Prognosis in Schizophrenia: 10-Year Longitudinal Follow-Up Study.
abstract: Although the duration of untreated psychosis (DUP) plays an important role in the short-term prognosis of patients with schizophrenia, their long-term prognosis generally is not determined by DUP alone. It is important to explore how other clinical factors in the early stage are related to DUP and consequent disease courses.
  
  
  
  A total of 664 patients with untreated psychosis were surveyed for this study. At the first examination, we divided them into the severe positive symptoms cases (SC) or the less severe cases (NonSC) and compared the prognosis among the two groups after a 10-year follow-up. In all, 113 patients in the SC group and 43 patients in the NonSC group were follow-up completers.
  
  
  
  Whereas DUP was not different between the two groups, patients with nonacute onset in both groups had significantly longer DUP than those in patients with acute onset. For all clinical measures, there was no difference in prognosis between the two groups or among the four groups classified by mode of onset (MoO) and initial severity of positive symptoms. However, the degree of improvement of global assessment of functioning (GAF) was significantly smaller in the NonSC-nonacute group than in the SC-acute and SC-nonacute groups.
  
  
  
  These results suggest that neither DUP nor MoO alone necessarily affects the initial severity of positive symptoms. Moreover, it is possible that patients with low impetus of positive symptoms onset within long DUP experience profound pathologic processes. Therefore, the current study results indicated that long DUP and nonacute onset were related to poor long-term prognosis, regardless of initial positive symptoms.
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan ; Division of Medical Treatment and Rehabilitation, Center for Forensic Mental Health, Chiba University, Chiba City, Chiba, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Kanahara
authors.forename: Taisuke
authors.initials: T
authors.lastname: Yoshida
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Oda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Moriyama
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shibuya
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Nagaushi
authors.forename: Takashi
authors.initials: T
authors.lastname: Sawa
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Sekine
authors.forename: Eiji
authors.initials: E
authors.lastname: Shimizu
authors.forename: Makoto
authors.initials: M
authors.lastname: Asano
authors.forename: Masaomi
authors.initials: M
authors.lastname: Iyo
mesh_terms: D000328:Adult; D017668:Age of Onset; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology*