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Tijdschrift voor Psychiatrie 45 (2003) 10, 597 - 608

New research

Predictors and the five-year course of early-onset schizophrenia. A path analysis

M.E. Lenior, P.M.A.J. Dingemans, A.H. Schene, D.H. Linszen

background  The heterogeneous course of schizophrenia is already signalled in the early phase. This means that it is worthwhile doing research into the predictors of the course of the illness in young patients.
aim  To analyse the effect of 19 possible predictor variables on 4 outcome variables in patients with recent-onset schizophrenia.
method  Patients who participated in a 15-month intervention programme (n = 64), were randomised over two conditions: standard intervention and standard intervention plus family intervention. Baseline variables were measured during the intervention. Outcome variables were measured over 5 years after discharge, and comprised: duration of psychotic episodes, living in institutions for psychiatric patients, structural activities and help from the family.
results Of the 19 baseline variables, 6 had a possible predictive value and were entered into a path analysis. The resulting model indicated that the duration of psychotic episodes is associated with living in institutions for psychiatric patients and with help from the family, but not with structural activities. The score on the Strauss & Carpenter prognostic scale predicts the duration of psychotic episodes. Diagnosis (schizophrenia v. schizophrenia-related disorder) predicts help from the family. The age at which the first psychotic episode occurred, predicts living in institutions for psychiatric patients.
conclusion  Baseline variables only partially predict the long-term course of schizophrenia. A composite scale predicts psychotic episodes more accurately than do separate demographic or illness-related variables.

keywords course of illness, longitudinal study, path analysis, predictors, schizophrenia