OBJECTIVES: The early course of schizophrenia is highly variable. We assessed outcomes of patients with first-episode schizophrenia at 7-year follow-up. METHODS: Consecutively hospitalized male patients were included if they were experiencing their first admission for first-episode schizophrenia and were reassessed at 1-, 4- and 7-year follow-ups. The psychopathology was evaluated using the PANSS, relative decrease of PANSS and remission status based on severity of core symptoms. RESULTS: Forty-four of 76 patients were reassessed three times. At the end of index hospitalization 73% of patients achieved remission; however, after 1, 4 and 7 years, the percentage had dropped to 50, 50 and 52%, respectively. When compared post-hoc there was no significant difference in PANSS and response to treatment between remitters and non-remitters during the index hospitalization; however, a significant difference in psychopathology emerged first after 1, 4 and 7 years. All patients who had not achieve remission after 1 year also failed to achieve remission after 4 and 7 years. CONCLUSIONS: Response to treatment during the first psychotic break-through may not be a decisive indicator for the outlook of the disease. Our data suggest that when deterioration occurs, it does so early after the first episode.

Department of Psychiatry Medical Faculty of Masaryk University and Faculty Hospital Brno Brno Bohunice Czech Republic

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