Socio-psychological Factors Concerned to 15 Years Long-term Outcome of First Onset Schizophrenics

这是一项前瞻性长期结局研究，收集了107例首发精神分裂症患者作为发病率研究队列。本研究的主要结果如下：1.随访结果：存活58例，死亡7例（随访率60.7%），脱落42例（39.3%）。自杀（即，4例和1例疑似病例），发病率为6%~ 8%。脱落病例大多数在首次接触后2年内脱落，2年、5年、10年和15年随访率约为60%。2.在生殖学结局方面，至少有30%的受试者已恢复。3.社会结局总体评价，39.7%的患者预后良好，55.2%的患者预后不良，与其他报道的比例相比，处于平均水平。4.长期病程中，约40%的患者为间歇性病程，持续性约占40%，中间性约占20%。本研究从精神病学、社会学和病程三个方面再次证实，精神分裂症患者的预后并不一定差，有些患者预后良好，有些患者长期处于低适应水平，表现为精神病性症状。发作类型、从发作到开始治疗的持续时间、发作症状的性质、首次发作的持续时间、早期治疗等），将研究发病前后的社会心理因素和病程/结局。

This is a prospective long-term outcome study with the subjects of 107 first onset schizophrenic patients collected for an incidence study cohort. Assessment scales used structured interview have obtained adequate inter-rater reliability beforehand.The main results of the study are as follows :1.Morbidity outcome is 58 alive and 7 dead (a follow-up rate is 60.7%), and 42 drop-out (39.3%). The suicide (i.e., 4 cases and one suspected case) rate among the subjects is 6%-8%. Most of the drop-out cases have dropped out within 2 years after first contact, and follow-up rates were about 60% at the times of 2-year, 5-year, 10-year and 15-year follow-ups.2.Regarding the symptomatological outcome, at least 30% of the subjects have recoverd. This supports the results of other reports.3.Evaluating social outcome in general, 39.7% of them had "good" outcome and 55.2% "poor", and compared to the percentages given in other reports, they are about in the average.4.Concerning long-term course, episodic course was seen in about 40% of the subjects, continuous in about 40% and in-between course in about 20%.These results are also similar to the other reports. Looking at the symptomatological, social outcome and course evaluated in this study, it is reconfirmed that the outcome of schizophrenia is not necessarily poor and some cases have good outcome, while some cases keep a low-adjustment level showing psychotic symptoms continuously over a long period of time.As a future study projects, the relationship between various clinical factors (e.x., onset type, duration of period from the onset to the start of treatment, nature of onset symptoms, duration of first episode, early-stage treatment, etc.), socio-psychological factors before and after the onset and course/outcome will be studied.