Recovery from psychotic illness: a 15- and 25- year international follow-up study

G. Harrison, K. Hopper, T. Craig, E. Laska, C. Siegel, J. Wanderling, K.C. Dube, K. Ganev, R. Giel, W. An Der Heiden, S.K. Holmberg, Aleksandar Janca, P.W.H. Lee, C. Leon, S. Malhotra, A.J. Marsella, Y. Nakane, N. Sartorius, Y. Shen, C. SkodaR. Thara, S.J. Tsirkin, V. Varma, D. Walsh, D. Wiersma

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    744 Citations (Scopus)

    Abstract

    Background Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.Aims To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.Method Historic prospective study. Standardised assessments of course and outcome.Results About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.Conclusions A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.Declaration of interest Funded by the Laureate Foundation, the World Health Organization and the participating centres (see Acknowledgements).
    Original languageEnglish
    Pages (from-to)506-517
    JournalBritish Journal of Psychiatry
    Volume178
    DOIs
    Publication statusPublished - 2001

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