Longitudinal studies of schizophrenic patients

A sample of 502 schizophrenic patients, who had been admitted to the University Psychiatric Clinic between 1945 and 1959, was systematically followed up between 1967 and 1973. The same well-defined diagnostic criteria were used throughout the study. At the time of the last followup, the average duration of illness was 22.4 years. Twenty-two percent of the patients showed complete psychopathological remissions, 43% had noncharacteristic types of remission, and 35 percent suffered from characteristic schizophrenic deficiency syndromes. Psychopathological outcome in the patients studied was assessed in relationship to such factors as duration of illness, social remission, family history of schizophrenia, primary personality, educational level, social class, age at onset, and presence of precipitating factors. It is concluded that prognostic predictions are possible only when several factors with a similar influence on long-term outcome occur in combination and when factors with a contrary prognostic influence are absent. Even under these circumstances, the individual course is by no means certain. The hypothesis that presenting symptomatology can be used to differentiate between true schizophrenias and schizophreniform psychoses is not supported.