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

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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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Background
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Result
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Self-citation
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Method
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“50)* Other psychoses 13,998 (33) 6,548 (38) 7,450 (30) 0.”
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Self-citation
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Result
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Background
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“In another review Bromet et al. (2005) focused on the diagnostic stability and outcome of schizophrenia as determined from long-term follow-up studies (some of the studies are shown in Table 6) initiated within the past 30 years.”
Background
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“In short, we would advocate that future outcome studies be designed more programmatically by including and testing potentially ‘modifiable’ risk factors that can subsequently be evaluated in experimental clinical research (Bromet et al. 2005).”
Background
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BackgroundResult
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Background
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Background
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“In addition, a more acute onset often confers a better prognosis than gradual onset (Bromet et al., 2005).”
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“Sample and Procedures Details about the design of the Suffolk County Mental Health Project (SCMHP) can be found elsewhere (Bromet et al., 1996; Bromet et al., 2005).”
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Attitudes of mental health clinicians toward perceived inaccuracy of a schizophrenia diagnosis in routine clinical practice
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“As schizophrenia is viewed to be a relatively clear diagnosis [23], we assumed that even frequent cases of inaccurate diagnosis would rarely rise above the 10% mark.”
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Cegla-Schvartzman, F., Ovejero, S., López‐Castromán, J., & Baca‐García, E. (2018) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000187 · Cited by 21
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“The earlier literature has often considered the family history of psychosis a sign of poor outcome in schizophrenia, although there are not many studies to support this reckoning (Bromet et al., 2005; Esterberg et al., 2010; Käkelä et al., 2014).”
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Diagnostic stability and outcome after first episode psychosis
Gale‐Grant, O., Dazzan, P., Lappin, J., Donoghue, K., Reininghaus, U., Croudace, T. J., Jones, P. B., Murray, R. M., Fearon, P., Doody, G. A., et al. (2020) · Journal of Mental Health · doi:10.1080/09638237.2020.1818191 · Cited by 14
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The MMPI ‐2 in chronic psychiatric illness
Bosch, P., van Luijtelaar, G., van den Noort, M., Schenkwald, J., Kueppenbender, N., Lim, S., Egger, J. I. M., & Coenen, A. M. L. (2014) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12152 · Cited by 11
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“Consistent with previous research with young FEP cohorts (Bromet et al., 2005; Simon et al., 2018; Wiersma et al., 1998; Yuen et al., 2014), we found that suicide and accidents (in particular, accidental poisonings) accounted for approximately 80% of mortality with a recorded cause in the 15 years…”
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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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Long-Term Diagnostic Stability and Outcome in Recent First-Episode Cohort Studies of Schizophrenia

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