Paranoid schizophrenia: prognosis under DSM-II and DSM-III-R

DSM-III-R subtype-specific criteria and Tsuang-Winokur demographic criteria for paranoid schizophrenia were applied to records of discharged schizophrenic inpatients diagnosed according to DSM-II. Those meeting DSM-III-R subtype-specific criteria for paranoid schizophrenia and those who did not, ie, they received more hopeful diagnoses, had equally good prognoses. Good outcome was associated with the presence of prior affective symptomatology, absence of formal thought disorder, or other negative-type symptoms as well as Tsuang-Winokur demographic criteria of onset after age 25, married or employed status, and/or absence of family history. Patients with particularly poor outcome were identified by the coexistence of unsystematized or poorly developed persecutory ideation, symptoms of thought disorder, and/or disorganized behavior. The clinical and demographic descriptors discussed in this report may be particularly useful in creating homogeneous patient groupings for both clinical and rate-setting payment classifications.