Schizophrenia Prognosis

The view on the schizophrenia prognosis has been very pessimistic in past years. The traditional clinical and societal viewpoint that it is a debilitating and deteriorating illness with poor outcomes.

Prospective studies have however shown that outcomes are heterogeneous, and not universally poor. The reasons for these varied outcomes is as yet not fully understood. Some factors which may be important are illness and compliance, resistance to medication, insight, stress, social support, coping mechanisms, and continued drug and alcohol abuse.

The rule of 1/3s can be applied. 1/3 will have good outcomes, 1/3 medium outcomes and 1/3 of patients will have poor outcomes.

Many patients manage to live independently or semi-independently. And most will need some form of financial, social support and daily living support.

The modern viewpoint is one of recovery where the patient takes an active role in the development of new meaning and purpose beyond "being a schizophrenic" (which is an outdated and inappropriate term) while coming to terms with living with an illness.

Prognostic factors

In terms of the schizophrenia prognosis, poor prognostic factors are: Male sex, slow insiduous onset of illness, poor insight into illness, alcohol and drug abuse, poor coping mechanisms, little social support, onset at young age, poor response to treatment and poor premorbid functioning.