Symptoms and psychosocial situation in schizophrenia - A prospective follow-up study

A representative sample of 156 new schizophrenia patients (DSM III) were examined at their first contact for psychosis and re-examined 2 and 5 years thereafter. The five clinical symptom dimensions (negative, delusional, hallucinatory, disorganization, depressive) described in an earlier study were correlated with the patients' psychosocial situation at each point of examination. The negative dimension was closely and comprehensively associated with the patients' actual psychosocial situation at all phases of the illness, and other dimensions (disorganization, delusions, hallucinations, and depression) at the 2nd and 5th follow-up year. Heterosexual and work development were the major predictors of clinical dimensions. On the other hand, the negative dimension and auditory hallucinations predicted a poor psychosocial outcome, and depressive and manic grandiose dimension a good one. The negative syndrome found in chronically hospitalized patients may be caused or modulated by both environmental and biologic factors. In the later phase of the illness depression is an important indicator of poor psychosocial situation and requires attention in the treatment of chronically schizophrenic patients. Clinical syndromes or dimensions found by the factor analytic method and their relations with psychosocial situation vary considerably with illness duration. This should be taken into account in evaluating the meaning of results obtained in different studies.