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Prognosis of a brief psychotic episode
  1. Toshi A Furukawa
  1. Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
  1. Correspondence to Toshi A Furukawa, furukawa{at}

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This is the third of a series of evidence-based case conferences. The main aim of this new series of papers is to help clinicians learn and apply the evidence-based approach in their own clinical practices. The clinical question that we seek to solve in each of these series emanates from a real clinical case. I have completely anonymised the scenario but I still hope it remains as real as it was. The presentation in this series may appear too brief and rushed but this is how evidence-based medicine can be practised by busy clinicians once you are familiar with the process. This issue's clinical question is about prognosis. The case conference below illustrates how to critically appraise and apply an article about prognosis. We anticipate that the next case conference (fourth of the series) will deal with a clinical question about side effects.

Clinical case


A 38-year-old woman.

Present illness

According to the husband who accompanied her, the patient has been an office worker in a small business in the neighbourhood for the last 10 years, and he had not noticed any change in her behaviour up until 2 days ago, when she reported malicious treatment she had received at work. She appeared distressed and depressed, and she told him how her colleagues in the office were talking ill about her behind her back and also were possibly plotting to poison her. At that time, the husband just laughed away her worries and told her to have a good night's sleep. The next day, she still looked pale and despondent but went to work without saying much.

It was during the second night that the patient started to repeat her comments about her maltreatments at work, and suggested that her colleagues were now hiding behind the house next door, trying to drive her mad or to …

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  • Competing interests TAF has received lecture fees from Eli Lilly, Meiji, Mochida, MSD, Pfizer and Tanabe-Mitsubishi, and consultancy fees from Sekisui and Takeda Science Foundation. He is diplomate of the Academy of Cognitive Therapy. He has received royalties from Igaku-Shoin, Seiwa-Shoten and Nihon Bunka Kagaku-sha. The Japanese Ministry of Education, Science, and Technology, the Japanese Ministry of Health, Labor and Welfare, and the Japan Foundation for Neuroscience and Mental Health have funded his research projects.