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This paper uses monthly symptom data on 90 first-onset schizophrenics in Madras, India, to characterize, in a continuous manner, the course of remission and relapse. Remission from the first episode occurs in about 6 months and in about 3 months for later episodes. Syndromes from the Present State Exam, assessed at the first episode, predict differentially to early and later parts of the course. Hypomania and simple depression predict early remission from the first episode; flat affect and grandiose delusions predict longer episodes and shorter remissions later in the course.

Objective: The aim of the study was to determine the clinical outcome in a group of first-episode schizophrenic patients on a 10-year follow-up. The social, demographic and clinical variables associated with poor outcome and gender differences in outcome were other issues addressed., Method: Ninety patients fulfilling Feighner's and ICD-9 criteria for schizophrenia, at Madras, India, were included for a 10-year follow-up. The Present State Examination and the Psychiatric and Personal schedule were administered at intake and at the end of every year. Clinical outcome was considered as a combination of the pattern of course and the presence of positive symptoms during year 10., Results: After 10 years, 76 of the 90 patients included were followed up, giving a follow-up rate of 84%. The clinical outcome was good in nearly 75% of the patients with almost all symptoms showing a steep decline at the end of 10 years. Fifty-nine subjects were asymptomatic at the end of the follow-up period and 12 were ill during the entire 10th year. Sexual, religious and grandiose delusions and flat affect at inclusion predicted a poor clinical outcome. More males had a poor outcome and spent a longer time in a psychotic state., Conclusions: There is evidence of a good outcome in the majority of first-episode schizophrenic patients after 10 years in keeping with other reports from developing countries. Certain variables at inclusion predicted a poor clinical outcome and males had a poorer outcome than females.

Background: This article focuses on the underlying structure and temporal course of the symptoms of schizophrenia., Methods: Ratings of symptoms in 90 schizophrenic patients were made each month for 10 years following the first hospitalization. The analytic methods consisted of cross-tabulation, dichotomous factor analysis, and bivariate dichotomous time series., Results: The factor analyses revealed positive and negative factors with a slight tendency to merge over time. The prevalence of positive and negative symptoms declined in the year following first hospitalization and was stable thereafter. Positive and negative symptoms in 1 month were highly predictive of the same type of symptoms in the next month. Neither type of symptom was strongly associated with the other type in the following month when both types were included in the model. The predictability of the process increased with time., Conclusions: With a few minor caveats, the results suggest that the positive and negative symptom clusters are independent, both cross-sectionally and longitudinally.

Ninety first-episode patients fulfilling ICD-9 criteria for schizophrenia were followed up prospectively for 10 years. Complete assessments were possible on 76. The pattern of illness was good in 67% of the cases, and the commonest patterns was one with recurrent episodes. Predictors of poor course and longer time spent in psychosis were identified. All positive and negative symptoms showed a steep decline at the end of 10 years. The results are discussed in the context of longitudinal research on the course of schizophrenia in developing countries.