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Published on: November 21, 2013
Recovery from psychotic illness: a 15- and 25-year international follow-up study
G Harrison1, K Hopper, T Craig
1Division of Psychiatry, University of Bristol, UK. G.Harrison@bristol.ac.uk
Background:
Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.
Aims:
To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.
Methods:
Historic prospective study. Standardised assessments of course and outcome.
Results:
About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.
Conclusions:
A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.
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