Of 49 schizophrenicpatientsfollowed up 12 monthsafter their first admissionto hospital, onlyabout 45% had experiencedno relapseand had no schizophrenicsymptoms;a poorer outcome was moreoften found in Feighnerpositivethan Feighnernegativeschizophrenic patients. The patients' overall level of unemployment had more than doubled to 51 %. In patients whose acute episodesrespondedto treatment, pimozidetaken once weekly as maintenance therapy was as effective as intramuscularflupenthixol decanoate, but tardive dyskinesiaappeared in two patients receivingweekly pimozide;the repeat psy chometric assessmentat 12 months found modest improvements, i.e. no evidence of intellectual decline, in Matrices, Block Design, and Digit Copying tests. Forty per cent of relativesstillshowed significantpsychological distress,which correlatedwith patients' schizophrenicsymptoms, and the relatives' socialfunctioningremainedpoorerthan that of a normal community sample.

Of 49 schizophrenic patients followed up 2 years after their first admission to hospital, 37% were well, 47% had been readmitted to hospital at some time over the 2 years, and 38% showed schizophrenic symptoms at follow-up. A poor outcome at 2 years was associated with male sex, poor outcome after the first 5 weeks of the first admission, negative schizophrenic symptoms on first admission, and a diagnosis of definite or probable schizophrenia using the Feighner criteria. Only 23% were in employment. A small double-blind discontinuation study of maintenance antipsychotic medication during the second year found more relapses in those switched to placebo medication. Repeat psychometric assessment at 2 years confirmed modest improvements found at 12 months; that is, there was no evidence of intellectual decline. Relatives showed no more psychosocial distress than that found in a normal community sample; what distress there was correlated with patients' schizophrenic symptoms.

ABSTRACT— Of 49 schizophrenic patients followed up 2 years after their first admission to hospital, 37% were well, 47% had been readmitted to hospital at some time over the 2 years, and 18mo showed schizophrenic symptoms at follow‐up. A poor outcome at 2 years was associated with male sex, poor outcome after the first 5 weeks of the first admission, negative schizophrenic symptoms on first admission, and a diagnosis of definite or probable schizophrenia using the Feighner criteria. Only 23% were in employment. A small double‐blind discontinuation study of maintenance antipsychotic medication during the second year found more relapses in those switched to placebo medication. Repeat psychometric assessment at 2 years confirmed modest improvements found at 12 months; that is, there was no evidence of intellectual decline. Relatives showed no more psychosocial distress than that found in a normal community sample; what distress there was correlated with patients’ schizophrenic symptoms.