THE PREDICTION OF RECOVERY IN SCHIZOPHRENIA

Abstract

The literature on recovery in schizophrenia has been reviewed, and six prognostic factors frequently occurring in many studies (including those of Kant and Langfeldt) were selected. The criteria were applied retrospectively to 60 carefully studied and definitely diagnosed schizophrenics. Thirty were judged to have "recovered," and an equal number were consecutively admitted controls. In nearly every case their personal physicians, who had no interest in the study and were unfamiliar with its hypothesis, performed the evaluation. The six criteria were (a) psychotic depressive heredity, (b) symptoms suggesting a de- pressive psychosis, (c) onset within six months before the fully developed illness, (d) presence of precipitating factors, (e) absence of a schizoid personality adjustment and (f) confusion or disorientation. When these factors were applied on a yes-no basis, it was possible to separate 83% of the patients who did recover at the expense of including only 3% who did not. As a rule, the recovered schizophrenic presented symptoms suggestive of an affective psychosis and often possessed an heredity positive for psychotic depression. The significance of the findings, however, would appear to be greatest in the evaluation of specific therapies rather than in the reclassification of schizophrenia. To separate at the onset of illness the schizophrenics who might recover with routine care, would be to make comparative results of new treatment more meaningful. The results of this paper suggest that such separation can be obtained with simple and relatively objective criteria.