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The British Journal of Psychiatry 174: 141-149 (1999)
© 1999 The Royal College of Psychiatrists
JL Vazquez-Barquero, MJ Cuesta, S Herrera Castanedo, I Lastra, A Herran and G Dunn
Department of Psychiatry, University Hospital Marques de Valdecilla, University of Cantabria, Santander, Spain.
BACKGROUND: We present the findings from the three-year follow-up of all first episodes of schizophrenia occurring during a two-year period in Cantabria (in Spain). AIMS: (a) To describe the clinical characteristics of the illness from the early stages of the disease, and (b) to study the long-term psychosocial adjustment and psychopathological evolution of these patients, identifying predictors for the course of the illness. METHOD: Of the original cohort of 86 patients, 76 (88.3%) were fully evaluated at three-year follow-up. Psychiatric assessment was performed (PSE-9 and SANS/SAPS). Social adjustment was evaluated using the Disability Assessment Schedule (DAS). Information regarding the clinical evolution and use of health resources was also gathered. RESULTS: The majority of patients with a first-contact diagnosis of schizophrenia failed to meet the criteria for a CATEGO diagnosis at follow-up. The SANS/SAPS assessments revealed a doubling in the proportion of patients with 'negative schizophrenia'. The pattern of clinical course was also evaluated, with 24 (31.5%) of the patients having a good outcome. Being male and having low social class tended to be associated with poor clinical outcome CONCLUSIONS: The outcome of schizophrenia is less pessimistic than was originally thought.
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