Table 3.

Clinical Outcomes or Patterns of Course, Prospective Studies

Site	Psychiatric Assessment	Follow-up (y)	• Clinical Outcomes ○ Patterns of Course (%)
Jamaica39	PSE	1	○ 13: 1-y relapse rate
Trinidad88	PSE	1	• 19.6: Poor outcomea
Chennai,b India43,46	PSE	1	• 28.6: Complete recovery without relapse or exacerbation
	PHSS
Rural Karnataka, India41	PANSS	1.5	• Much improvedc
São Paulo, Brazil64	PSE	2	• 23.8: Symptom free • 60.2: ≥1 psychotic symptom
Sichuan,d China29	PSE	2	• 22.1: Complete/partial remission • 71.6: Continued marked symptoms • 6.3: Further deterioration of illness
	GPIS		○ 8.3: Relapse rate per year
Multisite study, India22,25,26	PSE	2	○ 45.2: Complete recovery or no relapses, residual symptoms ○ 44.3: ≥1 relapses with complete or incomplete remissions ○ 10.5: Chronic psychosis
	PPHS
Chandigarh, India28	PSE	1.5–2.5	• 37.4: No/minimal psychotic symptoms • 28.6: Mild/moderate psychotic symptoms • 34.1: Chronic psychosis
Ilesa, Nigeria53	PSE	2.1–3.2	• 45.7: No current mental disorder • 36.2: Active/residual schizophrenia • 18.1: Other/Dead
	BPRS
Butajira, Ethiopia33	SANS	1–4	• 45-50: No positive symptoms during follow-upe • 24-54: No negative symptoms during follow-upf
	SAPS
Chandigarh, India27	NA	4.5–6+	○ 45: No psychotic symptoms, some nonpsychotic symptoms ○ 23: Relapses with remission ○ 32: Chronic psychosis
Multisite study, India22,25,26	PSE	5	○ 28.2: Complete recovery or no relapses, residual symptoms ○ 67.2: ≥1 relapses with complete or incomplete remissions ○ 4.5: Chronic psychosis
	PPHS
MLS, India20,21,30	PSE	10	○ 17.1: Complete recovery or no relapses, residual symptoms ○ 76.3: ≥1 relapses with complete or incomplete remissions ○ 6.6: Chronic psychosis
	PPHS
Bali, Indonesia23	DSM-IV-TR	11g	• 23.9: In remissionh • 19.6: In partial remission
MLS, India20	PSE	20	○ 8.2: Complete recovery or no relapses, residual symptoms ○ 83.6: ≥1 relapses with complete or incomplete remissions ○ 8.2: Chronic psychosis
	PPHS
WHO studies
Sofia, Bulgaria15	GAF-S	16	Last 2 y ○ 38.2: No psychotic symptoms ○ 12.7: Episodic ○ 45.5: Continuous psychotic symptoms ○ 3.6: Not classified
	BSPSS		16-y coursei ○ 41.8: Continuous psychotic symptoms ○ 54.5: Episodic ○ 3.6: Not classified
China (ISoS)15	GAF-S	12	Previous month • 48.2: None or mild symptoms • 29.2: Severe symptoms
	BSPSS		Last 2 y ○ 34.5: No psychotic episodes ○ 6.9: Episodic ○ 51.7: Continuously psychotic
Cali, Colombia (ISoS)15	GAF-S	26	Previous month • 31: None or minimal symptoms • 20: Mild symptoms • 20: Moderate symptoms • 30: Serious symptoms
			26-y course ○ 48.6: Episodicj ○ 18.1: ≥1 relapses with complete or incomplete remissions ○ 33.3: Continuous psychosis
Agra, India (ISoS)15	GAF-S	25	Previous month • 56.4 (men): none or mild symptoms • 77.3 (women): none or mild symptoms
	BSPSS		Last 2 y • 77.0: Recovered • 11.5: Severe symptoms
			○ 32.1: Asymptomatic for 21–25 y ○ 14.8: Asymptomatic for 6–20 y ○ 13.1: Asymptomatic for <5 y ○ 41.0: Symptomatic for entire period
Chandigarh (rural), India (ISoS)15	GAF-S	15	Previous month • 61: Recovered • 16: Moderate symptoms • 24: Mild symptoms
	BSPSS		Course previous 2 yk ○ 71: No psychotic episodes ○ 8: Episodic ○ 8: Continuously psychotic
Chandigarh (urban), India (ISoS)15	GAF-S	15	Previous month • 66: Recovered • 18: Mild symptoms • 11: Moderate symptoms • 5: Severe symptoms
	BSPSS		Course previous 2 yl ○ 64: No psychotic episodes ○ 9: Episodic ○ 19: Continuously psychotic
Ibadan, Nigeria11		2	2-y course • 81.7: Complete remission • 15.3: Incomplete remission • 2.0: Unremitting psychosis • 1.0: Unknown

Note: DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; PSE, Present State Examination; PHSS, Psychiatric History and Sociodemographic Schedule; PANSS, Positive and Negative Symptom Scale; GPIS, General Psychiatric Interview Schedule; PPHS, Psychiatric and Personal History Schedule; BPRS, Brief Psychiatric Rating Scale; SANS, Scale for Assessment of Negative Symptoms; SAPS, Scale for Assessment of Positive Symptoms; MLS, Madras Longitudinal Study; ISoS, International Study of Schizophrenia; GAF-S, Global Assessment of Functioning-Symptomatology; BSPSS, Bleuler Severity of Psychotic Symptoms Scale.

^aContinuation of initial psychotic episode, suicide, or recurrence of psychotic symptoms after being symptom free for at least 3 mo.

^bUntreated at baseline.

^cPANSS total score of 38.85.

^dOutcomes based on 95 subjects who did not receive treatment during follow-up.

^eSignificant reduction between baseline and follow-up (P < .001).

^fSignificant reduction between baseline and follow-up (P < .001).

^gFive-year retrospective study served as baseline.

^hPANSS total score of 74.50 (moderately ill); all PANSS scores unchanged from baseline at 5 y.

ⁱNo subjects were free of psychotic symptoms throughout the entire period.

^jOnly 4.2% had a single episode.

^kNo information on the other 13% of sample.

^lNo information on the other 8% of sample.