E ver since Bleuler published his account of nearly a lifetime's work with schizophrenia patients (1), there has been great interest in studying the long-term course of this illness. The evolution of schizophrenia's conceptualization from dementia praecox to a heterogeneous disorder with variable outcomes has been well documented. The multinational International Pilot Study of Schizophrenia (IPSS; 2) initiated by the World Health Organization (WHO) showed that it is eminently possible to use the same standardized criteria and instruments to compare the course and outcome of schizophrenia in different countries and cultures. Among the few studies with more than 15 years of follow-up have been those of Tsuang and Winokur (3), De Sisto and others (4), Huber and others (5), and Moller and others (6). However, the varying nature and size of the samples, the varying duration of follow-up, and the lack of uniform definitions 564