Predicting the long-term outcome of schizophrenia

1996 ◽  
Vol 26 (4) ◽  
pp. 697-705 ◽  
Author(s):  
G. Harrison ◽  
T. Croudace ◽  
P. Mason ◽  
C. Glazebrook ◽  
I. Medley
Keyword(s):  
Strong Predictor ◽  
Social Activity ◽  
Predictive Ability ◽  
Female Gender ◽  
Favourable Outcome ◽  
Extended Model ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Icd 10

SynopsisPredictors of long-term (13 year) outcome of schizophrenia are reported for a representative cohort of ‘treated incidence’ patients ascertained on their first contact with Nottingham psychiatric services between 1978–80. An initial (baseline) model including previously reported predictors of 2-year outcome (age, gender, ever married, acuteness of onset) and length of untreated illness was used to predict a range of outcome measures covering the domains of disability, psychopathology, hospitalization, employment, social activity, and global outcome. This model demonstrated significant prognostic ability across all non-hospitalization outcomes under both ICD-10 and ICD-9 diagnoses of schizophrenia, but was attenuated under broad (ICD-9 and CATEGO S, P or O) and restrictive (S+) diagnostic classifications. Female gender predicted more favourable outcome under all diagnostic classifications except S+. In an extended analysis, the addition of initial 2-year course type substantially increased the prognostic ability of the model under all diagnostic classifications and enabled over 30% of the variance in global ratings of disability and symptoms to be predicted. In this extended model female gender predicted more favourable outcome over and above the effect of course type, across most domains under ICD-10, and for disability and psychopathology under other diagnostic classifications. The inclusion of measures of psychopathology at the time of first assessment, pre-morbid functioning, and duration of index admission conferred only marginal additional predictive ability for respective outcomes in the domains of psychopathology, social activity, employment and hospitalization. Hospitalization during the past year was the most difficult outcome to predict under any model suggesting that resource utilization represents the ‘administrative outcome’ of schizophrenia and serves as a poor proxy for broader concerns in the era of community care. These data demonstrate that key demographic variables and the mode of onset influence the long-term course of schizophrenia, but that early course type is a particularly strong predictor.

scholarly journals Comparison of numerical and standard sarnat grading using the NICHD and SIBEN methods

2021 ◽  
Author(s):  
Brian H. Walsh ◽  
Chelsea Munster ◽  
Hoda El-Shibiny ◽  
Edward Yang ◽  
Terrie E. Inder ◽  
...  
Keyword(s):  
Predictive Ability ◽  
Roc Curves ◽  
Cerebral Injury ◽  
Neonatal Encephalopathy ◽  
Minimum Threshold ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Grading Systems ◽  
Good Agreement

Abstract Objective The NICHD and SIBEN assessments are adapted from the Sarnat grade, and used to determine severity of neonatal encephalopathy (NE). We compare NICHD and SIBEN methods, and their ability to define a minimum threshold associated with significant cerebral injury. Study design Between 2016 and 2019, 145 infants with NE (77-mild; 65-moderate; 3-severe) were included. NICHD and SIBEN grade and numerical scores were assigned. Kappa scores described agreement between methods, and ROC curves their ability to predict MR injury. Results Good agreement existed between grading systems (K = 0.86). SIBEN defined more infants as moderate, and less as mild, than NICHD (p < 0.001). Both numerical scores were superior to standard grades in predicting MR injury. Conclusion Despite good agreement between methods, SIBEN defines more infants as moderate NE. Both numerical scores were superior to standard grade, and comparable to each other, in defining a minimum threshold for cerebral injury. Further assessment contrasting their predictive ability for long-term outcome is required.

Abstract TP366: National Institutes of Health Stroke Scale (NIHSS) is a Potent Predictor of Outcome in Acute Intracerebral Hemorrhage

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Suzie Kazaryan ◽  
Nerses Sanossian ◽  
David S Liebeskind ◽  
Sidney Starkman ◽  
Marc Eckstein ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Strong Predictor ◽  
Final Diagnosis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Acute Cerebral Ischemia ◽  
History Of ◽  
Acute Intracerebral Hemorrhage ◽  
Ich Score

Background: Although the NIHSS is a well-validated tool in assessing neurological deficit and predicting long-term outcome in acute cerebral ischemia, its utility in ICH has not been extensively studied. As NIHSS is routinely obtained in cases of stroke prior to imaging, it is often available in ICH patients to potentially assist physicians in triage, prognostication, and risk-adjustment. Methods: We analyzed consecutive patients enrolled in the NIH Field Administration of Stroke Therapy-Magnesium (FAST-MAG) phase 3 trial whose final diagnosis was ICH. Trained study nurses performed the NIHSS in the Emergency Department (ED) shortly after arrival and the modified Rankin Scale (mRS) at 90 days. Primary outcomes were disability or death (mRS 3-6) and mortality. Candidate potential predictor variables, including NIHSS, ICH Score, and GCS, those with threshold of p<0.10 were candidate parameters for backward selection logistic regression to determine independent predictors of disability or death and of mortality. Results: Among the 384 ICH patients, age was mean 65 (±13); female 34%; race white 78%, black 10%, Asian 10%; Hispanic ethnicity 33%; and history of hypertension 78%. The ED NIHSS and GCS was performed a median 148 minutes (IQR 121-180) after last known well. Initial NIHSS was median 16 (IQR 9-16), GCS 15 (IQR 10-15), and ICH Score 1(IQR 0-2). NIHSS correlated with ICH Score (r=0.780) and GCS (r=0.860). At 90 days, median mRS was 4 (IQR 2-6), disability or death (mRS 3-6) was present in 70%, and mortality occurred in 26%. In predicting disability or death at 90 days, c statistics were: NIHSS 0.81, ICH Score 0.81, and GCS 0.72. NIHSS≥14 showed 72% sensitivity and 75% specificity. For mortality by 90 days, c statistics were: NIHSS 0.78, ICH Score 0.80, and GCS 0.73. NIHSS≥19 had 80% sensitivity and 70% specificity. On multivariate analysis age (OR 1.07, 95%CI 1.04-2.0) and NIHSS (OR 1.18, 95%CI 1.13-1.23) were independent predictors of disability and death. Conclusions: The initial NIHSS is a strong predictor of disability and death and good predictor of mortality after intracerebral hemorrhage, performing as well as the ICH Score and better than the GCS. Consideration should be given to routine performance and documentation of the NIHSS in ICH patients.

Prediction of outcome in neurotic disorder: a 5-year prospective study

1998 ◽  
Vol 28 (5) ◽  
pp. 1149-1157 ◽  
Author(s):  
H. SEIVEWRIGHT ◽  
P. TYRER ◽  
T. JOHNSON
Keyword(s):  
Initial Response ◽  
Favourable Outcome ◽  
Dysthymic Disorder ◽  
Response To Treatment ◽  
Behaviour Therapy ◽  
Neurotic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Predicting Outcome

Background. There have been no previous studies of the outcome of different neurotic disorders in which a prospective group with original randomization to treatment have been followed up over a long period. Such studies are important in identifying the factors associated with good and poor outcome.Methods. A 5-year follow-up assessment was made of a cohort of 210 psychiatric out-patients seen in general practice psychiatric clinics with a DSM-III diagnosis of generalized anxiety disorder (71), panic disorder (74) or dysthymic disorder (65) and randomized to drug treatment, cognitive and behaviour therapy, and self-help. A total of 182 of the patients (87%) were assessed after 5 years by examination of hospital and GP records using a standardized procedure and outcome determined with a four-point outcome scale.Results. One hundred and seven (60%) of the patients had a favourable outcome but the remainder continued to be handicapped either intermittently or continuously throughout the 5-year period. Analysis of the value of initial data in predicting outcome using polychotomous step-wise logistic regression revealed that five variables were significant predictors of poor prognosis: older age; recurrent episodes; the presence of personality disorder at entry; general neurotic syndrome at entry; and symptom severity after 10 weeks. The initial DSM diagnosis and original treatment given, together with ten other variables, were of no predictive value.Conclusions. The long-term outcome of neurotic disorder is better predicted by age, personality and recency of onset than by other clinical variables with the exception of initial response to treatment.

scholarly journals Long-term outcome after tricuspid valvectomy in a neonate with Candida endocarditis: a case report

2019 ◽  
Vol 29 (4) ◽  
pp. 528-530
Author(s):  
Ellen S. I. Vanhie ◽  
Ad J. J. C. Bogers ◽  
Willem A. Helbing
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Pulmonary Regurgitation ◽  
Favourable Outcome ◽  
Early Infancy ◽  
Term Outcome ◽  
Long Term Outcome

AbstractTricuspid valvectomy is a rare surgical intervention, and knowledge regarding long-term outcome in children is lacking. We report a favourable outcome 11 years after tricuspid valvectomy in early infancy without subsequent surgery or other cardiac interventions. Specific criteria for timing of re-intervention are lacking. Application of adult tricuspid and pulmonary regurgitation recommendations is helpful but has limitations.

scholarly journals Symptom remission at 12-weeks is a strong predictor for long term outcome

2019 ◽  
Vol 50 (14) ◽  
pp. 2464-2464
Author(s):  
Svein Friis ◽  
Ingrid Melle ◽  
Thomas H. McGlashan
Keyword(s):  
Strong Predictor ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Symptom Remission

The Significance of Stupor in the Long-Term Outcome of Chronic Schizophrenia

1989 ◽  
Vol 155 (3) ◽  
pp. 352-355 ◽  
Author(s):  
J. C. Rigby ◽  
S. M. Wood ◽  
R. H. S. Mindham
Keyword(s):  
Psychiatric Hospital ◽  
Mental State ◽  
Chronic Schizophrenia ◽  
Favourable Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Chronic Schizophrenic ◽  
Schizophrenic Patients ◽  
Similar Sample

The admission records of 271 long-stay chronic schizophrenic patients, resident in a large psychiatric hospital, were examined in order to identify those who had presented in stupor at the onset of their illness. Twelve patients were found (ten men and two women). When compared, in terms of current mental state and behaviour, with a similar sample of schizophrenics in whom stupor had been absent, significant differences between the two groups were detected, with those presenting in stupor demonstrating a less favourable outcome.

Disease Patterns for Patients (pts) with Chronic Myeloid Leukemia (CML) That Have BCR-ABL Transcript Levels > 10% At 3 Month of Therapy with Tyrosine Kinase Inhibitors (TKIs)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3757-3757
Author(s):  
Aziz Nazha ◽  
Hagop M. Kantarjian ◽  
Preetesh Jain ◽  
Elias J. Jabbour ◽  
Alfonso Quintás-Cardama ◽  
...  
Keyword(s):  
Research Funding ◽  
Strong Predictor ◽  
Chronic Phase ◽  
Transcript Level ◽  
Initial Therapy ◽  
Molecular Response ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival

Abstract Abstract 3757 Background: Response to TKIs in CML at 3 month is a strong predictor for long term outcome in CML patients treated with TKIs. Pts who do not achieve a BCR-ABL transcript level < 10% or a MCyR at 3 months have lower event-free survival (EFS) and perhaps overall survival (OS). However, pts have rarely changed therapy based on response at this early time points. The purpose of this analysis is to understand the patterns of disease progression and management in this group of patients. Patients and Methods: A total of 489 newly diagnosed CML pts that received initial treatment with TKIs: imatinib 400 mg daily (83) imatinib 800 mg daily (199), and second generation TKIs (2GTKIs) (207) in consecutive or parallel trials between 7/2000 and 6/2011 were included in this analysis. Cytogentic and molecular responses were evaluated every 3 month for the first year and then every 6 month. Event was defined as transformation to accelerated phase (AP) or blast phase (BP), loss of complete hematologic response (CHR), or loss of MCyR. Results: Among the 489 treated pts, 58 (12%) did not achieve a MCyR or BCR-ABL transcript level < 10 % at 3 months (26 pts (31%) received IM400, 19 (10%) IM800, and 13 (6%) 2GTKIs. Eleven of these pts (19%) had high sokal score at diagnosis (1 pt treated with imatinib 400, 7 with imatinib 800, 3 with 2GTKIs). By 6 months, 52/58 pts (90%) continued on their original therapy: 39 (67%) at the same dose and 19 (33%) with a decreased dose because of adverse events. No pt had a dose increase. Six pts had discontinued therapy by 6 month: 4 due to intolerance, 1 loss of CHR and 1 for progression to BP. At 6 month, 27 pts (47%) achieved MCyR or BCR-ABL transcript level < 10 %. At 12 months, 47 pts (81%) were still receiving their initial therapy, 11 pts (19%) had discontinued their initial TKI: 6 due to intolerance, 1 loss of CHR, 2 for progression to BP, and 2 for resistant disease. After a median follow up of 95 months, 17 pts (29%) continue to receive their initial therapy and their current disease status are: complete cytogenetic response (CCyR) in 14 (82%), 2 (12%) lost their CCyR, and 1(6%) pt who never achieve any cytogenetic or molecular response and remains in chronic phase on the same dose of imatinib for over 8 years. Among these 17 pts, 11 (65%) have MMR, 2 (12%) with MR4.5, and 4 (24%) have lost MMR (2 of them with loss of CCyR). The 5 years OS, EFS and transformation-free survival (TFS) for the patients who did not achieve any response at 3 month was 88%, 77%, and 94%, respectively. The OS, EFS, and TFS for the patients who subsequently achieved a response (MCyR or BCR-ABL transcript level < 10 %) at 6 month was 100%, 66%, and 95%, respectively vs those who continued to have no response 79%, 95%, and 100%, respectively (P = 0.17, 0.07, 0.99, respectively). Conclusions: Although BCR-ABL transcript level at 3 month may predict long-term outcome of pts with CML treated with TKIs, this represents a static, one-time measure. Assessing the response at 6 months of pts with poor response at 3 months may provide a better predictor of long term outcome. Disclosures: Cortes: Novartis: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Ariad: Consultancy, Research Funding.

scholarly journals Study of the Long-Term Results of Decompressive Craniectomy after Severe Traumatic Brain Injury Based on a Series of 60 Consecutive Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Gaétane Gouello ◽  
Olivier Hamel ◽  
Karim Asehnoune ◽  
Eric Bord ◽  
Roger Robert ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Favourable Outcome ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome

Background. Decompressive craniectomy can be proposed in the management of severe traumatic brain injury. Current studies report mixed results, preventing any clear conclusions on the place of decompressive craniectomy in traumatology.Methods. The objective of this retrospective study was to evaluate the results of all decompressive craniectomies performed between 2005 and 2011 for refractory intracranial hypertension after severe traumatic brain injury. Sixty patients were included. Clinical parameters (Glasgow scale, pupillary examination) and radiological findings (Marshall CT scale) were analysed. Complications, clinical outcome, and early and long-term Glasgow Outcome Scale (GOS) were evaluated after surgery. Finally, the predictive value of preoperative parameters to guide the clinician’s decision to perform craniectomy was studied.Results. Craniectomy was unilateral in 58 cases and the mean bone flap area was 100 cm2. Surgical complications were observed in 6.7% of cases. Mean followup was 30 months and a favourable outcome was obtained in 50% of cases. The initial Glasgow Scale was the only statistically significant predictive factor for long-term outcome.Conclusion. Despite the discordant results in the literature, this study demonstrates that decompressive craniectomy is useful for the management of refractory intracranial hypertension after severe traumatic brain injury.

Are There Predictive Factors for Long-Term Outcome after Withdrawal in Drug-Induced Chronic Daily Headache?

Cephalalgia ◽  
2001 ◽  
Vol 21 (6) ◽  
pp. 691-696 ◽  
Author(s):  
GG Tribl ◽  
P Schnider ◽  
C Wöber ◽  
S Aull ◽  
A Auterith ◽  
...  
Keyword(s):  
Chronic Daily Headache ◽  
Favourable Outcome ◽  
Drug Induced ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clear Cut ◽  
Standardized Interview ◽  
Daily Headache ◽  
Drug Overuse

Objectives To investigate prognostic factors for long-term outcome of patients after inpatient withdrawal because of drug-induced chronic daily headache. Procedures Fifty-five patients (36 females) were re-examined by means of a standardized interview after inpatient withdrawal. The mean observation period was 9.28 ± 2.85 years (mean ± sd; median 8.58; range 5.00–13.50). Results Five years after withdrawal, one-third of the patients (34.6%) had an overall favourable outcome, one-third (32.7%) had no recurrent drug overuse and reported a clear-cut improvement of headache, and one-third (32.7%) developed recurrent drug overuse. Most relapses occurred within 2 years, and a small percentage within 5 years. No predictors for long-term outcome after inpatient withdrawal were found. Conclusions All patients with drug-induced chronic daily headache should be considered as good candidates for inpatient withdrawal, and no patient should be excluded from that therapy.

A 15-year follow-up study of patients with panic disorder

2003 ◽  
Vol 18 (8) ◽  
pp. 401-408 ◽  
Author(s):  
Sven Andersch ◽  
Jerker Hetta
Keyword(s):  
Panic Disorder ◽  
Favourable Outcome ◽  
Drug Trial ◽  
Panic Attacks ◽  
Daily Functioning ◽  
Short Term Treatment ◽  
Term Outcome ◽  
Long Term Outcome

AbstractBackgroundPanic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms.AimsTo describe the long-term outcome of naturalistically treated PD.MethodsFifty-five outpatients with PD, who participated in a placebo-controlled drug trial of the efficacy of alprazolam and imipramine 15 years ago were reassessed with the same instruments used in the original study.ResultsComplete recovery (no panic attacks and no longer on medication during the last 10 years) was seen in 18% of patients, and an additional 13% recovered but were still on medication. Fifty-one percent experienced recurrent anxiety attacks whereas 18% still met diagnostic criteria for PD. The incidence of agoraphobia decreased from 69% to 20%. Patients with agoraphobia at admission tended to have a poorer long-term outcome according to daily functioning compared with patients without agoraphobia at admission, although both groups reported improved daily functioning at follow-up. Maintenance medication was common. No benzodiazepine abuse was reported.ConclusionPD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.

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