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Natural Course of Schizophrenic Disorders: A 15-Year Followup of a Dutch Incidence Cohort
Abstract
Data are presented on the 15-year natural course of schizophrenia and other nonaffective functional psychoses in a cohort of 82 first-contact cases from a circumscribed area in the Netherlands. The subjects were suffering from functional psychosis with International Classification of Diseases-Ninth Revision (ICD-9) diagnoses 295, 297, or 298.3-9 (broad definition of schizophrenia) on entry. Standardized assessments of psychopathology, psychological impairments, negative symptomatology, social disability, and use of mental healthcare were used. The study reveals a pattern of chronicity and relapses with a high risk of suicide: Two-thirds of the subjects had at least one relapse and after each relapse 1 of 6 subjects did not remit from the episode; 1 of 10 committed suicide; and 1 of 7 had at least one episode with affective psychotic symptoms that started on average 6 years after the onset of the schizophrenic disorder. Diagnoses were reclassified in five patients, according to DSM-III-R criteria for a bipolar disorder. The predictive power--in terms of time in psychosis and in partial or full remission--of demographic, illness, and treatment variables at onset of the illness was very limited. Insidious onset and delays in mental health treatment are risk factors that predict a longer duration of first or subsequent episodes. The importance of mental health treatment in regard to outcome is probably subject to change because an early warning and intervention strategy could prevent further damage and deterioration. Our data support the need for an adequate relapse prevention program as a priority for our mental health services.
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“Relapses may also lead to reduced response to previously effective antipsychotics, potentially contributing to treatment resistance [10–12].”
From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [10]
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Hospital treatment and management in relapse of schizophrenia in the UK: associated costs
Munro, J., Osborne, S., Dearden, L., Pascoe, K. C., Gauthier, A., & Price, M. J. (2011) · The Psychiatrist · doi:10.1192/pb.bp.109.027714 · Cited by 18
Early intervention in psychosis: a rural perspective
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Treatment-resistant schizophrenia: challenges and implications for clinical practice.
Šagud, M. (2015) · PubMed · Cited by 18
Long-acting risperidone improves negative symptoms in stable psychotic patients
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Course and outcome of schizophrenia and their prediction
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Early psychosis treatment in an integrated model within an adult mental health service
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Subjective and objective quality of life at first presentation with psychosis
Renwick, L., Drennan, J., Sheridan, A., Owens, L., Lyne, J., O'Donoghue, B. N., Kinsella, A., Turner, N., O’Callaghan, E., & Clarke, M. (2015) · Early Intervention in Psychiatry · doi:10.1111/eip.12255 · Cited by 17
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Metadata
- Authors
- Wiersma, D., Nienhuis, F. J., Slooff, C. J., & Giel, R.
- Affiliations
- University of Groningen (NL)
- Corresponding author
- Wiersma, D.
- ORCID
- Giel, R.
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-01-01
- Volume
- 24
- Issue
- 1
- Pages
- 75-85
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- OpenAlex
- W2121119246
- Cited by
- 649
- References
- 38
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 14 · 2023: 14 · 2022: 18 · 2021: 17 · 2020: 56 · 2019: 38 · 2018: 24 · 2017: 26 · 2016: 62 · 2015: 22 · 2014: 34 · 2013: 28 · 2012: 15
- FWCI
- 8.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- 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
- schizophrenia
- MeSH terms
- Suicide Prevention, Activities of Daily Living, Adolescent, Adult, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Netherlands, Psychiatric Status Rating Scales, Recurrence, Rehabilitation, Vocational, Schizophrenia, Schizophrenic Psychology, Suicide, Cohort Studies, Incidence, Disease Progression
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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