Background. This paper describes the 13-year outcome of an epidemiolog
ically defined and representative cohort of patients selected when the
y were experiencing their first episode of schizophrenia. Method. In a
18-year follow-up study of a cohort identified in Nottingham in 1978-
80, the outcome (symptoms, disability, residence and treatment) was as
sessed using standardised instruments. Results. Four of the original 6
7 patients with ICD-9 schizophrenia were lost to follow-up and five we
re dead: 52% were without psychotic symptoms in the last two years of
follow-up, 52% were without negative symptoms and 55% showed good/fair
social functioning. However, only 17% were alive at follow-up, withou
t symptoms and disability, and receiving no treatment. Conclusions. Th
e findings reported are similar to those of other long-term follow-up
studies of schizophrenia and also to 5-year follow-up studies. Kraepel
in's emphasis on the longitudinal implications of a diagnosis of schiz
ophrenia are supported, but may be over-pessimistic.