Long‐term course in schizophrenia: concepts, methods and research strategies

Abstract

Objective: This paper summarizes current knowledge about course and outcome in schizophrenia by selecting particular information and by drawing conclusions in the light of theoretical and methodological considerations, in order to illustrate future research strategies, as well as to consider novel targets of treatment. Method: Based on examples from the literature the concepts of course and outcome as well as intervening factors of course and outcome are discussed by considering study results within their methodological and theoretical framework restrictions. Results: The heterogeneity of the disorder, manifest in its variable phenomenology, illness course, treatment response and outcome, complicates research but at the same time offers clues to elucidate the heterogeneity of aetiology and pathogenesis. The search for intervening factors and predictors is of particular interest in order to explore the illness mechanisms. Conclusion: Future research should focus on the biopsychosocial determinants of course and outcome in methodologically improved long‐term studies.

One‐year outcome in first episode psychosis patients in the Swedish Parachute project

“…To our knowledge the Parachute project is unique in the integration of an epidemiological approach, efforts for intensive psychosocial and medical treatment of a large cohort of FEP patients, with a sufficiently long follow-up period (5 years) and comparing with Ôstandard treatmentÕ FEP populations (6,(24)(25)(26).…”

Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology

“…Journal of Psychopharmacology 25 (5) achieving late phase recovery (Crumlish et al, 2009;Gaebel and Frommann, 2000;Harrison et al, 2001;Harrow et al, 2005;Hopper and Wanderling, 2000). It is uncertain to what extent a better long-term prognosis might be mediated by effective prevention of relapse.…”

Prodromal Symptoms and Early Detection of Schizophrenia

“…The advantages of this procedure are that the prodromal symptoms of relapses are not as remote in time as those of the first episode and that their prognostic efficiency can be prospectively validated [100][101][102][103][104][105]. The results obtained were valuable, but of insufficient predictive power, presumably due to differences in the type of prodromal signs included in the assessments and insufficient monitoring of their development over time.…”