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The British Journal of Psychiatry (2001) 178: 154-158
© 2001 The Royal College of Psychiatrists

Natural course of schizophrenia: 2-year follow-up study in a rural Chinese community{dagger}

MAOSHENG RAN, PhD, MENGZE XIANG, MD, MINGSHENG HUANG, MD and YOUHE SHAN, MD

Institute of Mental Health, West China University of Medical Sciences, Chengdu, China

Correspondence: Dr Maosheng Ran, Institute of Mental Health, First University Hospital, West China University of Medical Sciences, Xiaoxue Lu, No 7, Chengdu Sichuan 610041, China

Declaration of interest Funding from the China Medical Board of New York.

{dagger} See invited commentary, p. 159, this issue.

Background A number of studies have questioned whether the natural course of schizophrenia is more favourable in ‘developing’ than ‘developed’ societies and whether culture is a factor in producing a favourable course.

Aims This prospective study tests the hypothesis that the natural outcome of schizophrenia would be favourable in a Chinese rural area.

Method We investigated all patients with schizophrenia, including patients who had not received any treatment, among 149 231 rural community population in Xinjin County, Sichuan in 1994. Those patients who had never received treatment were followed up for two years.

Results Three-quarters of patients with schizophrenia who had not been treated remained symptomatic. As the duration of illness increased, the illness became more serious. The clinical outcome of the drug-treatment group was significantly better than for patients who had not received any treatment.

Conclusions The natural clinical outcome of schizophrenia in the Chinese rural community was poor, and occupational functioning of patients with schizophrenia was comparatively better. Schizophrenia itself has a specific natural course — antipsychotic drug treatment and psychosocial treatment will produce an improvement in prognosis.




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