AN 8-YEAR FOLLOW-UP OF PATIENTS WITH DSM-III-R PSYCHOTIC DEPRESSION, SCHIZOAFFECTIVE DISORDER, AND SCHIZOPHRENIA

Objective: The purpose of this study was to investigate the long-term outcome of patients with functional psychoses. The functional status o f patients with mood-congruent and mood-incongruent psychotic depressi on, schizoaffective disorder, and schizophrenia was examined. Method: Ninety-two inpatients with nonmanic and nonorganic functional psychose s who had been discharged from the hospital were identified through in patient records. A blind rater used DSM-III-R criteria to assign resea rch diagnoses to the patients on the basis of the data gathered at adm ission. Seventy-one patients were located 8 years later, and personal interviews were conducted with them. Results: Baseline diagnosis was a powerful predictor of long-term outcome, even after controlling for a ge at onset and duration of episode at admission. Patients with psycho tic depression had much better outcomes than patients with schizoaffec tive disorder or schizophrenia. Fourteen (43.8%) of 32 patients with p sychotic depression were free from psychosis at follow-up, in marked c ontrast to those who bad schizoaffective disorder or schizophrenia, no ne of whom had recovered. Patients with schizoaffective disorder could not be distinguished from Patients with schizophrenia. Conclusions: T he prognosis of patients with major depression with mood-incongruent f eatures most closely resembles that of depressed patients with mood-co ngruent features, while patients with DSM-III-R schizoaffective disord er have a prognosis resembling that of schizophrenic patients. Patient s with psychotic affective disorders have a much higher likelihood of recovering from psychosis than do schizophrenic patients.