Journal of
Public Health and Epidemiology

  • Abbreviation: J. Public Health Epidemiol.
  • Language: English
  • ISSN: 2141-2316
  • DOI: 10.5897/JPHE
  • Start Year: 2009
  • Published Articles: 575

Full Length Research Paper

Multiple outcome parameters: A 10 year follow-up study of first-episode schizophrenia

Amresh Shrivastava1,2*, Nilesh Shah3, Megan E. Johnston4, Kristen Terpstra5 and Larry Stitt6
1Department of Psychiatry, Elgin Early Intervention Program for Psychosis, The University of Western Ontario, Ontario, Canada. 2Mental Health Resource Foundation, Mumbai, Maharashtra, India. 3LTMG Medical College University of Mumbai, India. 4Department of Psychology, University of Toronto, 100 St. George St., Toronto, Ontario, Canada, M5S 3G3, Canada. 5Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada. 6Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada N6A 5C1, Canada.
Email: [email protected]

  •  Accepted: 20 February 2013
  •  Published: 31 March 2013

Abstract

Schizophrenia is a disease with multiple dimensions, thus its treatment also results in differential outcomes. A number of clinically recovered patients do not recover in several other parameters of social functions which are necessary to lead a socially integrated and functional life, for example, the ability to work or live independently. Until recently, the outcome of schizophrenia has been measured primarily in terms of clinical symptoms. Although there have been revolutionary advances, it is undetermined, the extent to which these patients recover on both clinical and social parameters. This paper examines the status of comprehensive recovery on clinical and social parameters in hospitalized first-episode patients of schizophrenia in a long-term follow-up. 116 patients with first-episode schizophrenia in Mumbai, India, were followed for 10 years. Patients were assessed using clinical and psychopathological dimensions to determine levels of clinical and social recovery. Good outcomes on clinical parameter were seen in 61% of patients, while 46.7% obtained good quality of life, and 72.9% out of the total 116 patients were able to live independently; however, a significant number of these patients were still living with distressing residual symptoms, such as aggression, suicidality, and negative symptoms. The findings show that patient’s exhibit differential outcome on multiple parameters, and a significant number continue to live with distressing symptoms, despite continued treatment for long periods. More research is required in outcome measures of response to treatment in schizophrenia, which can represent the real-life situation of these patients.

 

Key words: Long-term outcome, clinical recovery, social recovery, multidimensional outcome, schizophrenia.