PREDICTORS OF CLINICAL AND SOCIAL OUTCOMES AFTER HOSPITALIZATION IN SCHIZOPHRENIA

A prospective cohort study of schizophrenia was carried out in Sao Pau lo, Brazil, in order to investigate clinical and social outcomes in sc hizophrenia and related psychoses after hospitalization. A sample of 1 24 individuals who were living in a defined catchment area and had bee n consecutively admitted to psychiatric hospitals in that area with cl inical diagnoses of non-affective functional psychoses was followed up for 2 years. Assessments of clinical status and social adjustment at inclusion and at 2-year follow-up were carried out by means of standar dized instruments, the PSE and the DAS. At the end of the follow-up pe riod, 120 subjects (96.8%) were traced, and 103 (83.1%) were re-assess ed. At the second assessment, the proportion of subjects with a nuclea r syndrome of schizophrenia had halved (from 68.3% to 32.7%), 23.8% we re symptom free and 60.2% showed at least one psychotic symptom. Prese nce of psychotic symptoms at follow-up was best predicted by education al level (less than 4 years of formal education) and an initial DSM-II I-R diagnosis of schizophrenia. The distribution of global social adju stment levels at 2-year follow-up was similar to that observed at the outset, with approximately one third of subjects showing good, one thi rd showing intermediate and one third showing poor global social adjus tment. Social disability was best predicted by longer duration of illn ess, worse social adjustment levels at inclusion and lower educational level.