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Background: The short-term course of schizophrenia is reported to be better in some developing country settings. The long-term course in such settings, however, has rarely been studied.Aims: To examine the long-term course and mortality of schizophrenia in patients with a poor 2-year course.Method: The report is based on two incidence cohorts of first-contact patients in urban and rural Chandigarh, India, originally recruited for the World Health Organization Determinants of Outcome of Severe Mental Disorders study. Patients were assessed using standardised instruments at 2- and 15-year follow-ups.Results: Ninety-two per cent of the patients with a poor 2-year course had a poor long-term course and 47% died - a nine times higher mortality rate than among patients with other 2-year course types.Conclusions: In this developing country setting, a poor 2-year course was strongly predictive of poor prognosis and high mortality, raising questions about the adequacy of care for such patients. [ABSTRACT FROM AUTHOR]

Background: This case-control study used data from Chandigarh, North India to investigate the association between antecedent fever and acute brief psychosis.Aims: To assess whether antecedent fever may be a biological correlate of acute brief psychosis, and contribute to the nosology of acute brief psychosis.Method: The study was based in an incidence cohort from two catchment areas, an urban and a rural site, that were part of the World Health Organization Determinants of Outcome study. The cases (n = 17) met criteria for acute brief psychosis; controls (n = 40) were patients with other acute and subacute psychoses. The Life Events Schedule was used to determine the presence of antecedent fever.Results: The crude odds ratio for fever as a risk factor for acute brief psychosis was 6.2 (P = 0.004). The odds ratio in a logistic regression analysis--adjusted for site, gender and CATEGO classification--was 11.2 (P = 0.003).Conclusions: Antecedent fever may be a biological correlate of acute brief psychosis. This finding supports the validity of this entity, and has implications for its aetiology and diagnosis. [ABSTRACT FROM AUTHOR]

Background: This study in North India compared acute brief psychosis--defined by acute onset, brief duration and no early relapse--with other remitting psychoses, over a 12-year course and outcome.Method: In a cohort of incident psychoses, we identified 20 cases of acute brief psychosis and a comparison group of 43 other remitting psychoses based on two-year follow-up. Seventeen people (85%) in the acute brief psychosis group and 36 (84%) in the comparison group were reassessed at five, seven and 12 years after onset, and were rediagnosed using ICD-10 criteria.Results: At 12-year follow-up, the proportion with remaining signs of illness was 6% (n = 1) for acute brief psychosis versus 50% (n = 18) for the comparison group (P = 0.002). Using ICD-10 criteria, the majority in both groups were diagnosed as having schizophrenia.Conclusions: Acute brief psychosis has a distinctive and benign long-term course when compared with other remitting psychoses. This finding supports the ICD-10 concept of a separable group of acute and transient psychotic disorders. To effectively separate this group, however, the ICD-10 criteria need modification. [ABSTRACT FROM AUTHOR]