PREDICTION OF OUTCOME FOLLOWING A FIRST EPISODE OF SCHIZOPHRENIA - A FOLLOW-UP-STUDY OF NORTHWICK PARK FIRST EPISODE STUDY SUBJECTS

Background. Although previous studies have attempted to identify predi ctors of outcome in schizophrenia, few have prospectively studied firs t episode patients for an adequate followup period. Method. The psycho pathological predictors of outcome were investigated in a subgroup of 51 subjects, originally included in the Northwick Park study of first episode schizophrenia who were followed up 7.3 years (s.d. 1.1, range 5.3-10.3) after first admission in the Harrow study. Forty-four subjec ts (24 men, 20 women) were traced. Outcome measures were time to first readmission, occupational level and total duration of hospital admiss ion at five years after first admission. Results. A survival analysis of time to first relapse revealed that the presence of subjective feel ings of depression (CATEGO syndrome SD) during the first admission was associated with early relapse while the presence of depressive delusi ons (CATEGO syndrome DD) and higher educational attainment protected a gainst early relapse. Total duration of hospitalisation at five years after first onset was positively associated with the presence of CATEG O syndromes SD and OD (biological features of depression) and negative ly associated with female sex. Poor occupational outcome was not signi ficantly associated with any psychopathological predictors. Conclusion s. Our findings challenge the conventional view that symptoms of depre ssion are associated with better outcome in schizophrenia.