Mortality and long-term course in schizophrenia with a poor 2-year course - A study in a developing country

Background The short-term course of schizophrenia is reported to be better in some developing country settings. The long-term course in such settings, however, has rarely been studied. Aims To examine the long-term course and mortality of schizophrenia in pati ents with a poor 2-year course. Method The report is based on two incidence cohorts of first-contact patien ts in urban and rural Chandigarh, India, originally recruited for the World Health Organization Determinants of Outcome of Severe Mental Disorders stu dy. Patients were assessed using standardised instruments at 2- and 15-year follow-ups. Results Ninety-two percent of the patients with a poor 2-year course had a poor long-term course and 47% died - a nine times higher mortality rate tha n among patients with other 2-year course types. Conclusions In this developing country setting, a poor 2-year course was st rongly predictive of poor prognosis and high mortality raising questions ab out the adequacy of care for such patients. Declaration of interest Partial support detailed in Acknowledgements.