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Very long-term outcome of psychotic disorders

Author

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  • Vaios Peritogiannis
  • Afroditi Gogou
  • Maria Samakouri

Abstract

Background: The outcome of schizophrenia and related psychoses is generally modest, and patients display high rates of disability. Aims: The aim of the review is to present an up-to-date account of the research on the very long-term outcome of psychotic disorders. Method: We conducted a search in the PubMed and Scopus databases for articles published since the publication of the very long-term data of the World Health Organization’s International Study of Schizophrenia (the ISoS study), over the last 18 years (from 2002 to 2019). Studies were included if they reported on at least 15-year outcome and if they had used valid and reliable tools for the estimation of the patients’ outcome in terms of symptomatology and functioning. Results: A total of 16 studies were included in this review, involving 1,391 patients with schizophrenia and related psychoses. Most were single-center studies, with moderate size samples of patients, and 11 were prospective studies. Very long-term outcome of psychotic disorders varies considerably among studies. Good outcome ranges from 8% to 73.8%, and it appears to be better in developing countries, whereas differences are less apparent among Western countries (8%–40.3%). Studies in different settings have used different methods involving a variety of samples of patients to estimate their outcome, whereas definitions of good and poor outcome also varied among studies. Longer duration of untreated psychosis was associated with worse outcome in some studies. Schizophrenia was found to have poorer long-term prognosis compared to other schizophrenia spectrum disorders. A large proportion of patients, ranging from 19% to 48.2%, were not on medication. Conclusion: Recent evidence on the very long-term outcome of psychotic disorders is in line with previous reports and suggests that prognosis remains rather modest. There are several limitations of current research regarding outcome definitions and study design that should be addressed by future research.

Suggested Citation

  • Vaios Peritogiannis & Afroditi Gogou & Maria Samakouri, 2020. "Very long-term outcome of psychotic disorders," International Journal of Social Psychiatry, , vol. 66(7), pages 633-641, November.
    • Handle: RePEc:sae:socpsy:v:66:y:2020:i:7:p:633-641
    DOI: 10.1177/0020764020922276
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    References listed on IDEAS

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    1. Omokehinde O Fakorede & Adegboyega Ogunwale & Akinwande O Akinhanmi, 2020. "Disability among patients with schizophrenia: A hospital-based study," International Journal of Social Psychiatry, , vol. 66(2), pages 179-187, March.
    2. Vaios Peritogiannis & Panagiota Nikolaou, 2020. "Functioning in community-dwelling patients with schizophrenia spectrum disorders in rural Greece," International Journal of Social Psychiatry, , vol. 66(2), pages 111-117, March.
    3. Subhashini Gopal & Greeshma Mohan & Sujit John & Vijaya Raghavan, 2020. "What constitutes recovery in schizophrenia? Client and caregiver perspectives from South India," International Journal of Social Psychiatry, , vol. 66(2), pages 118-123, March.
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    1. Vaios Peritogiannis & Maria Samakouri, 2021. "Research on psychotic disorders in rural areas: Recent advances and ongoing challenges," International Journal of Social Psychiatry, , vol. 67(8), pages 1046-1057, December.

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