Symptoms and psychosocial situation in schizophrenia - A prospective follow-up study

A representative sample of 156 new schizophrenia patients (DSM III) were ex amined at their first contact for psychosis and re-examined 2 and 5 years t hereafter. The five clinical symptom dimensions (negative, delusional, hall ucinatory, disorganization, depressive) described in an earlier study were correlated with the patients' psychosocial situation at each point of exami nation. The negative dimension was closely and comprehensively associated w ith the patients' actual psychosocial situation at all phases of the illnes s, and other dimensions (disorganization, delusions, hallucinations, and de pression) at the 2nd and 5th follow-up year. Heterosexual and work developm ent were the major predictors of clinical dimensions. On the other hand, th e negative dimension and auditory hallucinations predicted a poor psychosoc ial outcome, and depressive and manic grandiose dimension a good one. The n egative syndrome found in chronically hospitalized patients may be caused o r modulated by both environmental and biologic factors. In the later phase of the illness depression is an important indicator of poor psychosocial si tuation and requires attention in the treatment of chronically schizophreni c patients. Clinical syndromes or dimensions found by the factor analytic m ethod and their relations with psychosocial situation vary considerably wit h illness duration. This should be taken into account in evaluating the mea ning of results obtained in different studies.