National Institute of Mental Health Longitudinal Study of Chronic Schizophrenia: Prognosis and Predictors of Outcome
Abstract
We performed a longitudinal study of chronic schizophrenic patients who were hospitalized for research purposes at the National Institute of Mental Health (NIMH) Intramural Program in the 1970s and early 1980s. We assessed present course, outcome and predictor data from the initial cohort of 58 young chronic schizophrenic patients who were followed up for 2 to 12 years following their NIMH index hospitalization. At follow-up, the sample showed substantial functional impairment and levels of symptoms with only about 20% of the sample demonstrating a good outcome. In addition, strong intercorrelation was noted among the symptom and functioning indexes at follow-up. Moreover, neuropsychologic tests of frontal cortical functioning were significantly correlated with outcome levels of negative symptoms and social functioning but not with levels of positive symptoms. During the period from the index hospitalization to the follow-up assessment, 78% of the sample suffered a relapse, 38% attempted suicide and 24% had episodes of major affective illness. Furthermore, levels of positive and negative symptoms ascertained when patients received optimal neuroleptic treatment during the index hospitalization significantly predicted outcome levels of symptoms and functioning and time spent hospitalized during the follow-up period. In contrast, levels of index positive and negative symptoms ascertained during the drug-free state did not predict outcome symptoms or functioning. These data suggest that treatment response is a critical predictor variable. We examined the implication of these data for the course of illness in schizophrenics.
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- Authors
- Breier, A.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Breier, Alan
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 1991-03-01
- Volume
- 48
- Issue
- 3
- Pages
- 239
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W1965897737
- Cited by
- 626
- References
- 1
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 4 · 2022: 8 · 2021: 4 · 2020: 3 · 2019: 7 · 2018: 9 · 2017: 13 · 2016: 11 · 2015: 14 · 2014: 18 · 2013: 13 · 2012: 20
- FWCI
- 21.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- chronic schizophrenia, long-term outcomes, relapse, suicide attempts, affective illness, positive symptoms, negative symptoms, social functioning, functional disability, frontal lobe function, neuropsychological assessment, prognostic factors, clinical course, psychiatric inpatients
- MeSH terms
- Adult, Chronic Disease, Female, Follow-Up Studies, Frontal Lobe, Hospitalization, Humans, Longitudinal Studies, Male, National Institute of Mental Health (U.S.), Neuropsychological Tests, Probability, Prognosis, Psychiatric Status Rating Scales, Recurrence, Schizophrenia, Schizophrenic Psychology, Suicide, Attempted, Antipsychotic Agents, United States
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