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Published on: November 21, 2013
Exploring the longitudinal course of psychotic illness: a case-study approach
L Cortese1, A K Malla, T McLean
1Department of Psychiatry, University of Western Ontario, London Health Sciences Centre. Leonardo.Cortese@lhsc.on.ca
Objective:
Thirty-three patients with a diagnosis of a psychotic disorder (schizophrenia, bipolar disorder, atypical psychosis) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) were studied to qualitatively assess the longitudinal course of the disorder using a case-study approach.
Methods:
Weekly fluctuations in patient symptomatology and overall social and personal functioning using the Global Assessment Scale were assessed following index hospitalization. Patients were followed for 1 year.
Results:
The emergent courses showed no relationship to diagnosis but followed 3 general trends: 1) positive incline; 2) fluctuating; and 3) stable. Individual representations of each course were examined closely, and biological and psychosocial factors associated with each were evaluated.
Conclusions:
The results supported the longitudinal patterns and individual interactions of Strauss's Interactive Developmental Model. The clinical course of psychotic disorders may be represented by 3 patterns. Key factors in the interaction between patient and environment that generate important changes in the evolution of each illness were illustrated.
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