Multidimensional study of the outcome of schizophrenic patients 1 year after clinic discharge. Predictors and influence of neuroleptic treatment

Abstract

Several dimensions of the outcome of 86 schizophrenic patients were recorded 1 year after discharge from inpatient index-treatment to complete a prospective study concerning the course of illness (rehospitalization, symptoms, employment and social contacts). When compared with 75 psychiatric patients of other diagnostic groups, no differences were found other than a significantly longer average rehospitalization stay for the schizophrenic patients. Taking prognostic categories and the regularity of neuroleptic therapy conducted during follow-up into account, it was established that the social outcome status of schizophrenic patients is substantially determined by the original level at the time of index-treatment. In contrast, the rate of relapse and readmission depend significantly upon the continuity of neuroleptic treatment. More complex analyses show that particularly for patients already hospitalized several times, successful relapse prophylactic treatment also has a favorable influence upon the patients' symptoms in the sense of a more stable remission. This could be related to the finding that the more chronic patients apparently exhibit a delayed remission when they undergo a relapse. The findings are interpreted to the effect that continuous neuroleptic maintenance therapy is advantageous to the majority of the patients, and should be applied, in view of the fact that alternative therapy procedures such as neuroleptic interval strategies have not yet been sufficiently evaluated.