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Tijdschrift voor Psychiatrie 43 (2001) 8, 559 - 565

Review article

The 5-year outcome of schizophrenia after a first admission, in the western world

L. de Haan, T. Timmer, D.H. Linszen, M.E. Lenior, L. Wouters

background Literature concerning the outcome of schizophrenia shows a puzzling diversity of findings. Knowledge of outcome is necessary for treatment planning.
aims Meta-analysis of prospective research (and a review of retrospective research) concerning the 5-year outcome of schizophrenia after a first admission, in the western world.
methods Review of the literature and meta-analysis.
results For calculating the various results it was inevitable to combine different groups of searches, as a result of which the results are calculated with numbers of patiënts ranging between 90 and 410. Seventy percent of firstly admitted patients with schizophrenia are rehospitalised during the first five years. Seventy-nine percent of the patients has a psychotic relapse during the five years after first admission. Forty percent of the patients has psychotic symptoms at the end of  the five-year follow-up. Seventy percent has moderate to severe impairments at that time. More than three percent of these (young) patients dies during the five years after first admission, mostly by suicide.
conclusion The outcome of schizophrenia during the years after the first admission is heterogeneous and not favourable for many patients. Predictors of outcome which serve the clinical purpose are needed to enable differential treatment planning.

keywords course, first admission, meta-analysis, schizophrenia