A 10-year followup of remitting schizophrenics

Fifty-one patients who on admission in 1959-62 were diagnosed schizophrenic and yet achieved full remission were followed for 4-16 years (average 10 years). Subsequently, 20 of the remitting schizophrenics relapsed, spent an average of 25% of the followup period hospitalized, and could unambiguously be relabeled chronic schizophrenia. Except for brief relapses in a few cases, 31 patients maintained full remission throughout the followup period. What was most significant was that on first admission the 20 remitting schizophrenics who became chronic were just as reactive (i.e., manifesting acute onset, precipitants, and good premorbid adjustment) and almost as "affective" (i.e., manifesting depression and heredity positive for affective psychosis) as the 31 patients whose remissions were sustained. These findings support the hypothesis that remitting schizophrenics are not necessarily a discrete type of schizophrenic requiring fresh labels. Rather, such patients may be more simply classified as schizophrenics who get predictably better after their first admission.