Schizoaffective psychoses. A long-term follow-up

The study comprises 20 men who had shown admixtures of schizophrenic and affective symptoms during their first hospitalisation in a psychiatric hospital in Stockholm 1946-1957. The observation period was between 17 and 30 years. At the time of follow-up the group was rediagnosed on the basis of all information obtained. It was shown that this originally relatively homogeneous group was made up of a heterogeneous collection of illnesses. Definite schizophrenia formed the largest group (nine patients). Three patients had developed a definite manic-depressive disease and three severe alcoholism. The remaining five patients showed prominent symptoms of both schizophrenic and affective type. After the first hospitalisation 19 patients were recovered or improved. At the end of the follow-up period the corresponding number was eight. Twelve patients showed social recovery, i.e. were working or studying at the end of the follow-up period. Eighteen patients were at some time re-hospitalised for psychosis. The group, as a whole, spent 16% of the observation period hospitalised in a mental hospital - 6% in the outcome group recovered + improved and 21% in the outcome group were unimproved. The course was difficult to predict with the aid of factors usually considered prognostically favourable. The study stresses the need for prospective controlled studies based on a systematised after-care programme for patients who show symptoms of both schizophrenia and affective illness in their first attack.