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The British Journal of Psychiatry (2004) 184: 48-57
© 2004 The Royal College of Psychiatrists

Heterogeneity of outcomes in schizophrenia

3-year follow-up of treated prevalent cases

MIRELLA RUGGERI, MD, PhD

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy

ANTONIO LASALVIA, MD, PhD

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy

MICHELE TANSELLA, MD

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy

CHIARA BONETTO, DrStat, PhD

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy

MARIA ABATE, MD

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy

GRAHAM THORNICROFT, MD, PhD

Section of Community Psychiatry (PRiSM), Health Service Research Department, Institute of Psychiatry, London, UK

LILIANA ALLEVI, MD

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy

PAOLA OGNIBENE, MD

Department of Medicine and Public Health, Section of Psychiatry, University of Verona, Italy

Correspondence: Mirella Ruggeri, Dipartimento di Medicina e Sanitá Pubblica, Sezione di Psichiatria, Universitá di Verona, Ospedale Policlinico, 37134 Verona, Italy.Tel: +39 045 80 74 441; fax: +39 045 58 58 71; e-mail: mirella.ruggeri{at}univr.it

Declaration of interest None. The study has been supported by a grant from Fondazione Mario Lugli (Roma).

1 ‘Housewife’ includes both married and unmarried women.

Background Care for people with schizophrenia should address a wide range of outcomes, including professional and consumer perspectives.

Aims To measure changes in psychopathology, functioning, needs for care and quality of life; to develop predictive models for each outcome domain; and to assess the frequency of ‘good’and‘poor’ outcomes, as defined in a series of different definitions that use combinations of the four domains measured.

Method Three-year follow-up of a 1-year-treated prevalence cohort of 107 patients with an ICD–10 diagnosis of schizophrenia attending the South Verona community-based mental health service.

Results Mean symptom severity and some types of needs for care worsen, but quality of life shows no change.Functioning shows a non-significant trend to deteriorate.Between 32% and 42% of the variance in the four key outcomes was explained by our model. Different definitions of ‘good’and ‘poor’ outcome included 0–31% of patients, depending on the definition used.

Conclusions The 3-year outcome for schizophrenia depends on the domain of outcome used, whether staff or patient ratings are used and the stringency of the definitions used for good and poor outcome.




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