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The British Journal of Psychiatry (2001) 178: 71-75
© 2001 The Royal College of Psychiatrists

Mortality and long-term course in schizophrenia with a poor 2-year course

A study in a developing country

RAMIN MOJTABAI, MD and EZRA SUSSER, MD

Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA

VIJOY K. VARMA, FRCPsych, SAVITA MALHOTRA, MD, SURENDRA K. MATTOO, MD, ARUN K. MISRA, PhD and NARENDRA N. WIG, FRCPsych

Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence: Dr Ramin Mojtabai, 200 Haven Avenue, Apt. 6P, New York, NY 10033, USA. Tel: (212) 7818413; Fax: (212) 7816345; E-mail: rm322{at}columbia.edu

Declaration of interest None. Partial support detailed in Acknowledgements.

Background The short-term course of schizophrenia is reported to be better in some developing country settings. The long-term course in such settings, however, has rarely been studied.

Aims To examine the long-term course and mortality of schizophrenia in patients with a poor 2-year course.

Method The report is based on two incidence cohorts of first-contact patients in urban and rural Chandigarh, India, originally recruited for the World Health Organization Determinants of Outcome of Severe Mental Disorders study. Patients were assessed using standardised instruments at 2- and 15-year follow-ups.

Results Ninety-two per cent of the patients with a poor 2-year course had a poor long-term course and 47% died — a nine times higher mortality rate than among patients with other 2-year course types.

Conclusions In this developing country setting, a poor 2-year course was strongly predictive of poor prognosis and high mortality, raising questions about the adequacy of care for such patients.




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