70 schizophrenic outpatients have been treated continuously after index hospital discharge with neuroleptic drugs for an average of 14.3 years. In predicting their outcome in several dimensions (rehospitalization rate, symptoms, social and work adjustment, self ratings) differential predictor patterns could be confirmed, at most accounting for 65% of the outcome variance. In part work adjustment at follow-up cold be predicted by premorbid social and sexual adjustment as well as by working capability at index discharge. The most powerful predictor for the number of social relations was the former frequency of social contacts. Rehospitalization was related to higher neuroleptic equivalence dose at index discharge among other predictors, whereas presence of symptoms could be predicted e.g. by formerly longer hospital stays. Although at the beginning of the treatment our sample was classified as "process schizophrenic" on "classic" prognostic scales, 40-60% of our cases had a relative good outcome. This results and the considerable decrease of the rehospitalization rate from 0.57 before treatment to 0.11 during treatment stand for a clear treatment related improvement of the spontaneous prognosis. The partly mutually independence of the outcome criteria and predictor patterns underlines the importance of multiaxial diagnosis.

The antidepressive efficacy of TRH was investigated in 15 endogenous depressive patients in a double-blind cross-over design. The Hamilton depression scale, the AMP (PAS) system, v. Zerssen scale and thermometer scales were used. No therapeutic effect could be demonstrated. The blunted TSH-response to TRH, which has been described by other investigators, was confirmed. There was suggestive evidence of a psychoendocrinological relationship in the sense that the more severe the "somatic depressive" syndrome as calculated from the AMP system, and the more marked the diurnal variation of the endogenous type is, the lower are the basal TSH-values and the smaller the response to TRH. Thus, TRH may become a useful tool to identify subgroups of depressive patient populations.

In 33 schizophrenic patients treated continuously as outpatients with perazine over two decades, the rehospitalization rate decreased from 0.58 before treatment to 0.07 during treatment. The intensity of psychopathologic symptoms and the side effects were found to be remarkably low. The high intraindividual constancy of perazine plasma levels and the tight correlation between dose and plasma levels indicated satisfactory patient compliance. Plasma levels amounted to only 25% of those under acute treatment and correlated positively with the severity of the disease. Higher plasma levels coincided with more frequent side effects such as slightly pathologic liver function and moderate impairment of oral glucose tolerance. The results suggest that low-dose maintenance treatment of schizophrenic patients with oral neuroleptics is effective and relatively safe.