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Prognostic scale for chronic schizophrenia.

W S Fenton, T H McGlashan

    Schizophrenia Bulletin
    |January 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    A new prognostic scale for chronic schizophrenia offers better outcome prediction than existing methods. This 5-item scale assesses functioning and illness invasiveness, aiding long-term prognosis in schizophrenia patients.

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    Area of Science:

    • Psychiatry
    • Clinical Psychology

    Background:

    • Existing prognostic scales for schizophrenia are limited in chronic populations.
    • Premorbid functioning and chronicity are key predictors in acute/subacute schizophrenia but less useful long-term.

    Purpose of the Study:

    • To develop and validate a simple, reliable prognostic scale for chronic schizophrenia.
    • To create a tool independent of illness chronicity.

    Main Methods:

    • A 5-item, 12-point scale measuring prognosis based on highest adaptive functioning and illness "invasiveness".
    • Illness invasiveness assessed via genetic loading, reality testing erosion, and affect preservation.
    • Validated on 163 chronic schizophrenia patients from the Chestnut Lodge Followup Study.

    Main Results:

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    • The prognostic score enabled strong probabilistic statements about long-term outcomes.
    • Predictive accuracy for specific outcomes (institutionalization, work, social relations, global) was demonstrated.
    • Poor outcomes were predicted with greater sensitivity than good outcomes.

    Conclusions:

    • Prognosis in chronic schizophrenia reflects remaining variability in life course, not fixedness.
    • The new scale provides a valuable tool for predicting long-term outcomes in chronic schizophrenia.
    • The scale's focus on dynamic interplay of factors offers a novel approach to schizophrenia prognosis.