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Only 10% of people with schizophrenia show sustained improvements over 3 years

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What proportion of people with schizophrenia have favourable long-term outcomes, and which factors predict a more favourable outcome?


2327 adults treated for schizoaffective disorders or schizophrenia (DSM-IV)and participating in the United States Schizophrenia Care and Assessment Program (US-SCAP). The majority of participants were outpatients (93.5%).


Community mental health centres, community and state hospitals, university healthcare systems, and Department of Veterans Affairs Health Services, USA; from July 1997 to September 2003.

Prognostic factors

Sixty-two factors were assessed as possible prognostic variables, including patient-reported variables, clinician-rated variables and medical record based resource utilisation. Symptom severity was assessed at baseline and annually using the Positive and Negative Symptom Scale score. Acute healthcare utilisation (hospitalisation, emergency services) was assessed using medical records. Quality of life and functional outcomes (eg, volunteering, working for pay, attending school, caring for children and keeping house) were assessed (SCAP Health questionnaire, Global Assessment of Functioning, Quality of Life Scales) at enrolment and every 6 months. Depressive symptoms were assessed at enrolment and annually (Montgomery-Asberg Depression Rating Scale). Medication adherence and medication effects, including adverse events (Simpson-Angus Scale) and tardive dyskinesia (Abnormal Involuntary Movement Scale) were assessed annually. Socio-demographic data were collected at baseline.


Sustained favourable long-term outcome. The health state …

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