THE IOWA LONGITUDINAL-STUDY OF RECENT-ONSET PSYCHOSIS - ONE-YEAR FOLLOW-UP OF FIRST-EPISODE PATIENTS

The natural history of schizophrenia remains unclear. One strategy to further inform this area is to prospectively evaluate individuals earl y in the course of the disorder, both in terms of symptomatic and psyc hosocial/occupational functioning. Subjects were recruited into the st udy if they were in the midst of their first psychiatric hospitalizati on for a non-'organic' psychotic disorder. Subjects were extensively e valuated at index with semi-structured interviews including the Compre hensive Assessment of Symptoms and History (CASH), and followed at 6-m onth intervals. Data are presented on 35 subjects who were followed th rough 1 year. There was a significant improvement in overall symptomat ology during index hospitalization, but this was accounted for primari ly by improvement of positive symptoms, with negative symptoms remaini ng prominent. No further improvement was noted between discharge and 1 -year follow-up in any of the symptom measures. Employment, interperso nal relationships, and sexual activity remained markedly impaired thro ughout the follow-up period. These data demonstrate that; (1) negative symptoms are prominent and stable early in the course of the disorder ; (2) symptom severity at discharge from index hospitalization is pred ictive of symptom severity at 1 year; and (3) despite substantial over all symptomatic improvement during the first hospitalization, psychoso cial and occupational functioning were found to be markedly impaired a t 1-year follow-up.