Follow-up of first episode schizophrenic patients: a review
background Follow-up studies are important to help us understand the course and underlying mechanisms of schizophrenia and related disorders.
aim This literature review aims at describing the actual state of affairs of follow-up research about schizophrenia.
method Literature published between 1980 and 2000 was selected by means of a Medline search. Follow-up, outcome, first episode, schizophrenia and the different predictors of outcome were used as keywords.
results In most studies women had a better outcome than men. A longer duration of untreated psychosis tends to predict a worse outcome. Concerning the effect of age at onset on outcome the results are not unequivocal, although there are indications for an interaction effect with gender. Continuous antipsychotic treatment decreases the relapse rate. The presence of an affective component seems to be a predictor for a better outcome. The results regarding the effect of family history are mainly inconsistent too. In many cases the effect of the different predictors can be confounded because they are not clearly defined and distinguished.
conclusion This review indicates that there is no clarity about some important predictors of outcome. Due to the large methodological differences between studies a comparison is hampered and future researchers are compelled to give a precise description of the study design.