Catamnestic Long-term Study on the Course of Life and Aging of Schizophrenics

Ciompi, Luc; Clemens, Sara

doi:10.1093/schbul/6.4.606

Cited by 431 publications

(238 citation statements)

References 21 publications

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“…10,15,19,21,27,[31][32][33][34][35] Our study highlights the importance of suicide prevention, not only during the early years but also later in the course of the illness.…”

Section: Resultsmentioning

confidence: 86%

Schizophrenia, An Illness with Bad Outcome: Myth or Reality?

et al. 2011

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Objective: Different myths about schizophrenia endorsed by clinicians maintain the pessimism about outcome thus reducing chances of improvement. There are no recent North American studies on the long-term outcome of first-episode schizophrenia to clarify if these beliefs are myths or reality. Our study describes the long-term outcome (10 to 16 years) of a first-episode schizophrenia incidence cohort (n = 142) in a Canadian urban centre between 1983 and 1999.Method: Clinical and social functioning at different time points were assessed retrospectively from medical files of a catchment area hospital in Montreal. Service use and deaths were noted from provincial databases of physician billings, hospitalization, and vital statistics.Results: Hospitalization days decreased considerably after the first year, with a small minority still needing it episodically after 4 years. Marital and occupational status were generally stable over time, but autonomy in living arrangements worsened. Thirty-three percent of subjects quit the Catchment Area Specialized Psychiatric Services. This group showed better social functioning while they were followed, were hospitalized less afterwards, and had fewer suicides, therefore indicating a better outcome for them. At the end of our study, 15% of the patients still alive were well enough to function without seeking medical help and 25% were not taking antipsychotic medication. Better outcome was predicted by older age at admission, being married, higher premorbid autonomy in living arrangements, and female sex. Conclusion:A significant proportion of first-episode schizophrenia patients achieve moderate long-term outcome, and the stability of global functioning is more frequent than deterioration, as shown in most industrialized countries.Can J Psychiatry. 2011;56(2):92-101. Clinical Implications• The heterogeneity of outcome widens as duration of follow-up increases, and a proportion of schizophrenia patients might function without long-term medication.• Occupational deficit stability suggests it should be the target of early intervention programs to prevent significant deterioration of functioning and of later supported employment rehabilitation approaches.• The decline in autonomous housing suggests early supported housing in the community, in collaboration with relatives, when patients move from their parents' home. Limitations• Our sample covered most of the catchment-area incident schizophrenia patients, but was limited to patients hospitalized at least once.• The functioning of a proportion of subjects could not be assessed until study end, but many of them were functioning without seeking medical help.• No symptomatology measures were included, therefore no correlations could be made between symptoms and functioning.

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“…10,15,19,21,27,[31][32][33][34][35] Our study highlights the importance of suicide prevention, not only during the early years but also later in the course of the illness.…”

Section: Resultsmentioning

confidence: 86%

Schizophrenia, An Illness with Bad Outcome: Myth or Reality?

et al. 2011

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“…Another possibility could be that the processes of aging and the possibility of psychopathological improvement during the later stages of schizophrenia (Bleuler, 1978;Ciompi, 1980;Harding et al, 1987;Mason et al, 1995) "neutralize" each other, producing effectively unchanged performance across this age span. The clinical measures used in this study (e.g.…”

Section: Discussionmentioning

confidence: 99%

Aging and visual motion discrimination in normal adults and schizophrenia patients

Bidwell

Holzman

Chen

2006

Psychiatry Research

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Motion perception is impaired in many neuropathological conditions, including schizophrenia. Motion perception also declines in the course of normal aging. In this study, we ask whether aging is an additive factor in the motion-discrimination deficits of schizophrenia patients. We examined motion perception in schizophrenia patients (n =44) and non-psychiatric controls (n =40) whose ages ranged from 18 to 55. The tasks included velocity discrimination and contrast detection. Thresholds for each of the two tasks were determined for each subject using psychophysical methods. Schizophrenia patients showed significantly increased thresholds (degraded performance) for velocity discrimination compared with the controls. Degraded performance in patients was not related to age. In controls, however, velocity discrimination thresholds were significantly increased beginning by age 45. Performance on a contrast-detection task, which does not require precise discrimination of motion signals, was not significantly affected by age in either group. Aging, even in its early stages, degrades motion discrimination in normal adults. Aging, however, does not adversely affect motion-discrimination deficits in schizophrenia patients through age 55. A similar motion-discrimination deficit in schizophrenia patients and aging normal adults suggests that the mechanisms underlying motion processing in schizophrenia and normal aging may be associated.

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“…18 Strauss and Carpenter 19 evaluated the progression of schizophrenia over time and found that most symptoms improve in 20% of patients, remain unchanged in 60%, and worsen in only 20% of patients. Ciompi 20 suggested that advancing age might mitigate the intensity of schizophrenic illness, allowing more patients to live as outpatients with residual states.…”

Section: Schizophreniamentioning

confidence: 99%

Treating Psychotic Symptoms in Elderly Patients

Targum¹

2001

Prim. Care Companion CNS Disord.

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Catamnestic Long-term Study on the Course of Life and Aging of Schizophrenics

Cited by 431 publications

References 21 publications

Schizophrenia, An Illness with Bad Outcome: Myth or Reality?

Schizophrenia, An Illness with Bad Outcome: Myth or Reality?

Aging and visual motion discrimination in normal adults and schizophrenia patients

Treating Psychotic Symptoms in Elderly Patients

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