Risk for suicide in schizophrenia and other psychotic and nonpsychotic disorders

Article Abstract:

Almost 600 male and female patients (with an average age of 21 years at first hospitalization), diagnosed with schizophrenia and other mental disorders, were followed-up for an average of 9 to 17 years after their first hospitalization. Major predictors of suicide among these young, mentally disabled patients were assessed. The patients came from mixed ethnic backgrounds. Diagnostic interviews, tests and clinical evaluations determined that the patient group included 148 schizophrenics, 181 patients with schizoaffective psychotic disorder (schizophrenic-like disorder in which no organic basis for psychosis can be found), 84 patients with psychotic mood disorder (e.g., depression or mania), 30 patients with other types of psychotic disorders (e.g., paranoia), and 165 patients with nonpsychotic disorders such as clinical depression. Approximately 9 percent of the schizophrenics had committed suicide by the end of the follow-up period, and about 7 percent of the patients with non-schizophrenic psychoses committed suicide. In both groups there was a higher rate of suicide for men than for women. About 4 percent of the nonpsychotic patients committed suicide. Nonpsychotic suicide rates were nearly equal for men and women. A significantly higher number of psychotic depressives committed suicide than nonpsychotic depressives. The patient characteristics most associated with suicide were male sex, Caucasian, single marital status, relatively high IQ scores, a history of drug abuse, and a gradual rather than acute onset of psychosis. The majority of suicides were carried out during the first six years of illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Causes of, Risk factors, Suicide, Psychiatric hospital patients, Psychoses, Psychotic disorders

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Clinical course and outcome of schizophrenia in Cali, Colombia: a 10-year follow-up study

Article Abstract:

In order to evaluate the course and outcome of schizophrenia, a 10-year follow-up study of 101 patients living in Cali, Colombia was carried out. Clinical assessment of the patients included the use of standardized examinations at the onset and at completion of the study. The final data analysis included 76 patients who had been consistently available for monitoring during the 10-year period. The patients were between 15 and 44 years of age, and predominantly male. Over the 10-year span, there was a significant reduction in single status and a concomitant increase in married or separated status. Psychotic episodes and total period of hospitalization were of short duration for most patients. Nine percent of the patients were never hospitalized, and only 8 percent were hospitalized for more than six months. The average time spent in the hospital was 73 days. The mortality for the patient group was very low (2 percent). Most patients demonstrated significant improvements in occupational and general economic level over time. Sociodemographic, personal, clinical, and historical factors were examined in terms of their ability to predict illness outcome. None of the study variables were shown to be significantly related to 10-year outcome. While a diagnosis of paranoid schizophrenia tended to remain unchanged over the course of the study, other clinical types of schizophrenia (e.g., simple, hebephrenic or chronic undifferentiated types) were shown to be unstable. Overall, the findings cannot be used to confirm the traditional view that schizophrenia follows a continuous and deteriorating course. (Consumer Summary produced by Reliance Medical Information, Inc.)

Colombia

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The prediction of outcome in schizophrenia IV: eleven-year follow-up of the Washington IPSS cohort

Article Abstract:

The study of schizophrenia has focused heavily on predictors of prognosis. In the past, research has sought to identify predisposing personality features and sociodemographic aspects of the illness. To study the long-term effect of these factors, the Washington International Pilot Study of Schizophrenia was begun. Patients were diagnosed as schizophrenic, and data were collected on several sociodemographic factors. Follow-up was done at two and at five years after the study began; re-evaluation was performed 11 years later, at which time 40 patients were available. Prognostic indicators based on symptoms, such as social and occupational functioning and hospital utilization, did not correlate well with one another, and did not have more than moderate predictive value for long-term outcome. This is contrary to data from early research, which strongly suggested that such variables determined outcome. Interestingly, these variables became less predictive over time. For example, restricted affect (mood) at initial interview was a predictor of five-year outcome, but not of 11-year outcome. It is possible that the characteristics of schizophrenia plateau early in the course of illness. After which time, there may be an even distribution of patients who improve compared with those who do not. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Predictive value of tests, Predictive value of tests (Medical)

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