Schizophrenia: a 13-year follow-up. Diagnostic and psychopathological aspects

In Denmark about 11-12 per 100,000 population are diagnosed as schizophrenics for the first time each year. Less than half of these receive this diagnosis at first admission and therefore only 5-6 per 100,000 are included in the official schizophrenia incidence figures. In a cohort (n = 53), predictors for diagnosis of schizophrenia at the first admission were analysed (vs. first schizophrenia diagnosis only at a later admission). In accordance with the Danish concept of schizophrenia, affective flattening was found to have a significant correlation with the initial diagnosis of schizophrenia. Long duration of disease prior to the initial admission was also significantly correlated, indicating that a criterion of chronicity forms part of the Danish concept of schizophrenia. Schneider's first-rank symptoms also were more weakly correlated with the initial schizophrenia diagnosis. The probands were followed up personally and by case records (13 years). Good outcome was found in 23% of the probands and poor outcome in 50%. Affective flattening and Schneiderian first-rank symptoms at initial admission were correlated with poor outcome (NS). Schneiderian first-rank symptoms and social unease at initial admission were significantly correlated with schizophrenia as follow-up diagnosis. The initial clinical diagnosis of schizophrenia was not correlated with clinical outcome or with follow-up diagnosis.