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Cited by 129Schizophrenia research and treatmentMental Health and PsychiatryPsychopathy, Forensic Psychiatry, Sexual Offending

Long-Term Diagnostic Stability and Outcome in Recent First-Episode Cohort Studies of Schizophrenia

Bromet, E. J·2005·Schizophrenia Bulletin
DOI 10.1093/schbul/sbi030
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Abstract

Knowing the long-term outcomes of schizophrenia and stability of a schizophrenia diagnosis are important from a clinical standpoint as well as essential to future research on diagnostic classifications and outcome. As in prior research on schizophrenia, prospectively designed long-term studies over the past 30 years find that the predominant course of illness includes chronically poor functioning, with little evidence of long-term improvement. Mortality due to suicide is significant at about 10% over 10-year periods of follow-up. Within studies, outcome domains are interrelated, and the relatively consistent predictors of poorer outcome include family history of schizophrenia, insidious onset, poor premorbid functioning, severity of negative symptoms, and severity and duration of untreated psychosis. Residing in a developed rather than a developing country is also associated with a poorer long-term course. The diagnostic stability of schizophrenia is less well studied. The positive predictive value exceeds 90%, and preliminary findings from the 10-year follow-up of the Suffolk County Mental Health Project cohort have found that the agreement across time increased from k = .52 (baseline to 10 years) to k = .76 (6 or 24 months to 10 years). After discussing several limitations of the existing body of research, we suggest that future studies incorporate more "modifiable" risk factors into the assessment battery that could potentially be used as building blocks in experimental intervention designs.

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  • Course qualifiers allow differentiation of first- and multiple-episode cases, and between acute episodes with symptoms, full or partial remission, and chronic course due to different prognostic implications.

    “Course qualifiers allow the differentiation of first- and multiple-episode cases, and between acute episodes with symptoms, full or partial remission, and a chronic course due to different prognostic implications [26].”

    From Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies (2020) · cites this paper as [26]

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Authors
Bromet, E. J.
Affiliations
Stony Brook University (US)
Corresponding author
Bromet, E. J
ORCID
Bromet, E. J
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2005-07-27
Volume
31
Issue
3
Pages
639-649
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1707
DOI
10.1093/schbul/sbi030
OpenAlex
W2138826206
Cited by
129
References
47
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 5 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 6 · 2016: 2 · 2015: 3 · 2014: 11 · 2013: 5 · 2012: 20
FWCI
5.24
Type
journal article
Language
en
Open access
closed
Locations
  • Schizophrenia Bulletin (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH044801, MH44801)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords
schizophrenia, long-term outcomes
MeSH terms
Adult, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Male, New York, Prognosis, Risk Factors, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Suicide, Cohort Studies

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