The Course of Schizophrenia Over 13 Years

1996 ◽  
Vol 169 (5) ◽  
pp. 580-586 ◽  
Author(s):  
Peter Mason ◽  
Glynn Harrison ◽  
Cristine Glazebrook ◽  
Ian Medley ◽  
Tim Croudace
Keyword(s):  
Social Adjustment ◽  
First Episode ◽  
First Year ◽  
Survival Curves ◽  
Course Of Illness ◽  
First Relapse ◽  
Late Recovery ◽  
Representative Cohort ◽  
First Episode Of Schizophrenia

BackgroundThis paper describes the 13 year course of illness in an epidemiologically defined and representative cohort of patients selected when they were experiencing their first episode of schizophrenia.MethodIn a 13-year follow-up study of 67 patients with ICD–9 schizophrenia, identified in Nottingham in 1978–80, the course of illness (symptoms, disability and hospitalisation) was assessed using standardised instruments, applied at onset 1, 2, and 13 years. Time to first relapse and first readmission were calculated and plotted as survival curves and patients were assigned to the course types described by Ciompi.ResultsThe survival curves show that first relapses and first readmissions occur during the first five years. The amount of time spent in psychotic episodes and in hospital is greatest in the first year of follow-up, but stable thereafter. Social adjustment improves from entry to the study to the first follow-up year, but there is a small deterioration in social adjustment between 2 and 13 years.ConclusionsThe findings reported suggest that after the initial episode the course of schizophrenia is relatively stable. The data support neither concepts of progressive deterioration nor progressive amelioration. There was no evidence of a ‘late recovery’.

How “DUP” and “EE” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Cechnicki ◽  
R. Polczyk ◽  
A. Bielańska
Keyword(s):  
Repeated Measures ◽  
First Episode ◽  
First Year ◽  
List Type ◽  
Type Number ◽  
Long Term Outcomes ◽  
Course Of Illness ◽  
Negative Syndrome

Objective:The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.Subjects and methods:58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. The Follow-Up Chart, BPRS, and CFI were used. As the outcome criteria only dynamic of symptoms were included. The dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.Results:1.General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). The negative syndrome decreased less rapidly during the first year.2.The dynamic of general and positive syndrome were modified by the DUP and by EE. In long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. After the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).3.The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).Conclusion:The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. The dynamic of negative syndrome was not modified by DUP and EE.

How “DUP” and “ee” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Cechnicki ◽  
R. Polczyk ◽  
A. Bielańska
Keyword(s):  
Repeated Measures ◽  
First Episode ◽  
First Year ◽  
List Type ◽  
Type Number ◽  
Long Term Outcomes ◽  
Course Of Illness ◽  
Negative Syndrome

Objective:The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.Subjects and methods:58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. the Follow-Up Chart, BPRS, and CFI were used. as the outcome criteria only dynamic of symptoms were included. the dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.Results:1.General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). the negative syndrome decreased less rapidly during the first year.2.The dynamic of general and positive syndrome were modified by the DUP and by EE. in long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. after the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).3.The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).Conclusion:The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. the dynamic of negative syndrome was not modified by DUP and EE.

Characteristics of Outcome in Schizophrenia at 13 Years

1995 ◽  
Vol 167 (5) ◽  
pp. 596-603 ◽  
Author(s):  
Peter Mason ◽  
Glynn Harrison ◽  
Cristine Glazebrook ◽  
Ian Medley ◽  
Tim Dalkin ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Lost To Follow Up ◽  
Representative Cohort ◽  
First Episode Of Schizophrenia

BackgroundThis paper describes the 13-year outcome of an epidemiologically defined and representative cohort of patients selected when they were experiencing their first episode of schizophrenia.MethodIn a 13-year follow-up study of a cohort identified in Nottingham in 1978–80, the outcome (symptoms, disability, residence and treatment) was assessed using standardised instruments.ResultsFour of the original 67 patients with ICD–9 schizophrenia were lost to follow-up and five were dead: 52% were without psychotic symptoms in the last two years of follow-up, 52% were without negative symptoms and 55% showed good/fair social functioning. However, only 17% were alive at follow-up, without symptoms and disability, and receiving no treatment.ConclusionsThe findings reported are similar to those of other long-term follow-up studies of schizophrenia and also to 5-year follow-up studies. Kraepelin's emphasis on the longitudinal implications of a diagnosis of schizophrenia are supported, but may be over-pessimistic.

Depression in people with first-episode schizophrenia

1998 ◽  
Vol 172 (S33) ◽  
pp. 90-92 ◽  
Author(s):  
Donald Addington ◽  
Jean Addington ◽  
Scott Patten
Keyword(s):  
Acute Phase ◽  
Depression Scale ◽  
First Episode ◽  
First Year ◽  
Multiple Episode ◽  
Treatment Of Depression ◽  
One Year ◽  
First Episode Schizophrenia ◽  
First Episode Of Schizophrenia

Background Depression has been described in people presenting with first-episode schizophrenia, a group at high relative risk of suicide.Method This was a longitudinal cohort study of 113 people during an acute relapse and 13 having a first episode. Follow-up occurred at three months and at one year. This report compares level of depression in the first episode and in the relapsing group. Levels of depression were assessed using the Calgary Depression Scale for Schizophrenia (CDSS).Results The median CDSS score was statistically significantly higher in the first-episode group both during the acute phase and at three month follow-up. At one year the first-episode group continued to have higher levels of depression than the multiple episode group.Conclusions For people with a first episode of schizophrenia, depression is a major problem during the initial acute phase and during the first year of illness. In light of the high risk of suicide in this population, recognition and treatment of depression requires greater attention.

Predictors of outcome in first-episode schizophrenia over the first 4 years of illness

2008 ◽  
Vol 38 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
P. Whitty ◽  
M. Clarke ◽  
O. McTigue ◽  
S. Browne ◽  
M. Kamali ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode ◽  
Global Assessment Of Functioning ◽  
Methodological Issues ◽  
Course Of Illness ◽  
Dsm Iv ◽  
First Episode Schizophrenia ◽  
The Relationship ◽  
Positive And Negative Symptoms

BackgroundThe outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.MethodWe conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.ResultsThere were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=−3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=−2.77, p<0.01) significantly predicted a better outcome at follow-up.ConclusionsThe outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.

scholarly journals S215. FRONTO-TEMPORAL CEREBRAL BLOOD FLOW AND COGNITIVE FUNCTIONING IN PATIENTS WITH FIRST EPISODE PSYCHOSES TREATED WITH ARIPIPRAZOLE: PRELIMINARY FINDINGS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S120-S120
Author(s):  
Vjekoslav Peitl ◽  
Ante Silić ◽  
Draženka Ostojić ◽  
Branka Aukst Margetić ◽  
Ines Šiško Markoš ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cognitive Functioning ◽  
Cognitive Functions ◽  
First Episode ◽  
Beneficial Effects ◽  
Core Symptoms ◽  
99Mtc Hmpao ◽  
First Episode Of Schizophrenia

Abstract Background Cognitive dysfunctions have long been observed in patients with schizophrenia, while cognitive symptoms are receiving a lot of attention due to the fact they can be considered core symptoms of schizophrenia. Cerebral blood flow has been by some researchers associated with cognitive functioning, or at least some aspects of cognitive functions. Because of its distinctive psychopharmacologic properties, aripiprazole is deemed a substantially different antipsychotic compared to the majority of the available compounds. It has been hypothesised that due to this fact it could have beneficial effects especially on cognition in schizophrenia. In line with that thought, the objective of this study was to investigate whether use of an atypical antipsychotic aripiprazole has beneficial effects on cerebral blood flow and cognitive functioning in patients with a first episode of schizophrenia during a three month treatment. Methods Forty patients were included in the ongoing study. At baseline and at three month follow up schizophrenia symptomatology was assessed by PANSS, cognitive functions by 5-KOG screening instrument for cognition in psychiatry, while cerebral blood flow was assessed by 99mTc-D,L-hexamethylene-propyleneamine oxime (99mTc-HMPAO) using a SPECT technique. Results After three months of treatment, we observed a significant improvement of schizophrenia symptoms and cognitive functions, measured by PANSS and 5-KOG, with all of the five subscales of the latter and its total score being significantly higher than at baseline (p&lt;0.05). Similarly, cerebral blood-flow measured by SPECT improved at three months follow up compared to baseline. Discussion Use of aripiprazole in first episode patients with schizophrenia is associated with increased fronto-temporal cerebral blood flow and improvement of schizophrenia symptomatology, including cognition indices. Although we cannot confirm it directly, it is possible that improved fronto-temporal cerebral blood flow led to the improvement in cognition indices.

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