European versus U.S. data on the course of schizophrenia
Article Abstract:
The course and outcome of schizophrenia have been difficult to study, despite several investigations over the last 20 years, because of the lack of standard criteria that would allow meaningful comparison of data sets. The differences across studies can be attributed to different diagnostic criteria, observational techniques, outcome criteria, and differences in sampling. A group of 74 schizophrenics was studied in the US under a research protocol that was designed to conform closely to a research protocol used in Europe. The two European studies contained 208 patients in one study and 289 patients in the other. The intent was to compile a data set that could be compared with the European data. Patients in the US study were an average of 20.8 years old at their first hospitalization, 65 percent were men, 72 percent were white, and 49 percent were middle- or upper-class. All were hospitalized at the time of their initial evaluation and data about illness onset, frequency, duration, previous episodes, and adjustment prior to illness were collected. Each patient's psychosocial situation was comprehensively evaluated as well, and patients were re-evaluated three times over a period of 10 years. At the end of 10 years, the US patients were found to have a lower rate of acute onset schizophrenia (i.e., a schizophrenic episode that did not become chronic) than their European counterparts; they also had fewer episodes. However, for the most part, the data were similar between groups. The authors conclude that it is possible to collect data on schizophrenia for comparison across studies if a careful approach is taken. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
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Outcome of schizoaffective disorder at two long-term follow-ups: comparisons with outcome of schizophrenia and affective disorders
Article Abstract:
Schizoaffective disorder is characterized by symptoms of both schizophrenia and affective illness, which include mood disorders such as depression. Whether it is a form of schizophrenia or affective illness, part of a continuum of both, or a completely separate condition, remains a topic of debate. The approaches to solving this dilemma take a variety of directions, one of which is to compare the outcome of those with schizoaffective disorder, schizophrenia, and affective disorder. A group of 101 psychiatric patients were assessed, which was composed of 41 schizoaffective patients, 20 schizophrenics, 20 patients with bipolar illness, and 20 patients with major depressive illness. Functioning and overall adjustment were assessed for all patients at initial intake, two years after hospitalization, and four-to-five years after discharge. Overall, schizoaffective, schizophrenic, and bipolar patients functioned more poorly than depressives after discharge from the hospital. These results did not change over time; at two-year follow-up, depressed patients had the highest level of functioning, followed by those with bipolar disorder, subjects with schizoaffective disorder, and schizophrenics; at the second follow-up, this pattern remained the same. Overall, the outcome of schizoaffective patients was similar to both schizophrenics and those with affective disorders, making it likely that schizoaffective disorder is not just a variant of affective disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
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Cyclothymic mood swings in the course of affective disorders and schizophrenia
Article Abstract:
Cyclothymia refers to the phenomenon of cyclic changes in mood, such as occur with manic depressive illness at the extreme ends of the mood spectrum. To assess relationships between cyclothymic mood swings and psychosocial adjustment, 38 depressed (unipolar), 27 manic depressive (bipolar) and 27 other psychiatric patients were studied four years after hospital discharge; a control group of 153 normal subjects was also included in the study. The patients had much greater mood swings than the control group, but among the patients, there were no significant differences. In terms of the ability to function and cope after hospitalization, the cyclothymic patients were much less adept than the other psychiatric patients. The findings suggest either that cyclothymia itself interferes with psychosocial function, or else cyclothymic mood swings result from a broader underlying factor that increases the probability of poor social functioning. The authors suggest the latter hypothesis is more likely, and indicate that minor mood swings in patients who have a hard time adjusting after psychiatric hospitalization may in fact be reflecting a persistent vulnerability to psychopathology.
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1989
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