[A study on relapse of schizophrenic patients--10-year-follow-up investigation after initial admission]

Ten year prognosis of schizophrenic patients after their initial admission was studied. The subjects of the present investigation were 106 schizophrenic patients who fulfilled the criteria for schizophrenia of DSM-III-R and were initially admitted to a hospital between January 1979 and December 1984. They were classified into following five groups: 1) a discontinuing group (39 patients who could not be followed up because of changing the hospital or ceasing outpatient treatment), 2) an unrelapsing group (29 patients who had no relapse in continuing medication), 3) an A group (13 patients who relapsed in spite of continuing medication), 4) a B group (22 patients who relapsed only after discontinuing medication), and 5) a C group (3 patients who relapsed in continuing medication as well as after discontinuing medication). These groups were compared in multiple domains such as age at onset, age on initial admission, duration from onset to initial admission, etc. The average age at onset was significantly older in the unrelapsing group (29.0 years) than in the A group (22.1 years) (p < 0.05). The average age on initial admission was significantly older in the unrelapsing group (35.2 years) than in the A group (25.0 years) (p < 0.01). Furthermore the average duration from onset to initial admission was significantly longer in the unrelapsing group (70.9 months) than in the A group (23.8 months) (p < 0.05). Assuming theoretical groups considered in points of tendency of relapse and the effect of neuroleptics on the prevention in each patient, as well as theoretical subgroups considered in points of biological pathology and nonbiological pathology as factors of relapse, the following two subgroups were abstracted from the groups of this study: a subgroup with a high effect of medication on the prevention of relapse and the other with a low effect. There were significant differences in the average age at onset, age on initial admission, duration from onset to initial admission, and duration of initial admission between these two subgroups. These different onset pattern suggest that the effect of medication on relapse is different among patients. Our results indicate existence of a group of schizophrenic patients whose relapse can not be prevented by current neuroleptic therapy.