Studies on relapse, course and outcome of schizophrenia in Japan

Studies of the long-term outcome of schizophrenia in Japan are reviewed. In nine studies over a 10 year period, recent reports on three patient cohorts show that the liability to relapse is the major difficulty in the treatment and care of schizophrenia. Other research on relapse-related problems in schizophrenia are also reviewed. Relapses appear mainly in the first decade after onset of the condition; in stressful situations related to a family or larger social context; and on cessation of psychotropic drugs. Relapse liability develops during the course of schizophrenia, but the characteristics of the relapses vary with both the duration and the episodic nature of the schizophrenic condition. Two types of unique treatments that are specifically aimed at coping with relapses, and which were developed in Japan, are described: 'Seikatsu-Rinsho' (clinical guidance to the way of life) and 'Soegi-Ryoho' (splint therapy).