A five-year followup study of deficit and nondeficit schizophrenia

Previous studies have suggested that deficit schizophrenia is a stable subtype of schizophrenia, and that patients with the deficit schizophrenia have different course of illness from other people with schizophrenia. We tested the ability of the deficit/nondeficit categorization to predict clinical features at five years' followup in a group of chronically ill outpatients. Outpatients categorized into deficit (N = 46) and nondeficit (N = 174) schizophrenia were assessed at an average of five years after the categorization was made. Raters making the followup assessments were blind to the initial categorization. At followup, the deficit patients had poorer quality of life, poorer social and occupational function, and more severe negative symptoms. Despite these differences, deficit patients were less distressed (as measured by depressive mood, anxiety, and guilt), and they did not have more severe hallucinations, delusions, thought disorder. These differences could not be attributed to demographic differences. The group differences in quality of life and level of psychosocial function remained significant after accounting for the severity of baseline negative symptoms. These findings confirm that patients with the deficit schizophrenia have a set of relatively stable clinical features that are associated with poor outcome.