THE EFFECT OF CLOZAPINE ON THE COURSE OF ILLNESS IN CHRONIC-SCHIZOPHRENIA - FOCUS ON TREATMENT OUTCOME IN OUT-PATIENTS

Forty-eight consecutive schizophrenic patients treated with clozapine (mean daily dose 436 mg) for at least 1 year (mean 7.6, range 2.2-14.8 years) were studied retrospectively. The most favourable changes in t he course of illness were observed in 39 out-patients, whose duration of hospitalization per year continuously and significantly declined af ter the introduction of clozapine. The out-patients who continued with clozapine treatment for more than 10 years (n = 8) did not need hospi talization at all during the last year of the observation period. The improvement in social functioning in the outpatient group correlated p ositively with the duration of clozapine medication (r = 0.384, p = 0. 016) and with the duration of hospitalization (r = 0.372, p = 0.020) a fter introduction of clozapine. Out-patients with disorganized schizop hrenia (later called hebephrenic according to the Finish version of DS M-III) showed more noticeable clinical (U = 226, p = 0.032) and social (U = 233, p = 0.024) improvements than non-hebephrenic patients. Ther e appears to be a subgroup of hebephrenic patients who benefit from cl ozapine more than patients with other types of schizophrenia.