Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-03T08:50:51.817Z Has data issue: false hasContentIssue false
  • English
  • Français

Outcome and its predictors in schizophrenia within the Northern Finland 1966 Birth Cohort

Published online by Cambridge University Press:  16 April 2020

E. Lauronen ,
J. Miettunen ,
J. Veijola ,
M. Karhu ,
P.B. Jones  and
M. Isohanni
E. Lauronen*
Affiliation:
Department of Psychiatry, University of Oulu, P.O. Box 5000, FIN-90014 University of Oulu, Finland
J. Miettunen
Affiliation:
Department of Psychiatry, University of Oulu, P.O. Box 5000, FIN-90014 University of Oulu, Finland
J. Veijola
Affiliation:
Department of Psychiatry, University of Oulu, P.O. Box 5000, FIN-90014 University of Oulu, Finland Academy of Finland, Helsinki, Finland
M. Karhu
Affiliation:
Department of Psychiatry, University of Oulu, P.O. Box 5000, FIN-90014 University of Oulu, Finland
P.B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, UK
M. Isohanni
Affiliation:
Department of Psychiatry, University of Oulu, P.O. Box 5000, FIN-90014 University of Oulu, Finland Department of Public Health and General Practice, University of Oulu, Oulu, Finland
*
*Corresponding author. Tel.: +358 40 7474376; fax: +358 8 333167. E-mail address: [email protected] (E. Lauronen).
Get access

Abstract

Purpose

We report clinical and social outcomes of schizophrenia in the longitudinal, population-based Northern Finland 1966 Birth Cohort, and describe associated demographic, developmental and illness-related factors.

Subjects and methods

Subjects with DSM-III-R schizophrenia (n = 59) were followed prospectively from mid-gestation up to age 35 years. Outcome measures included positive and negative symptoms, psychiatric hospitalisations, social and occupational functioning. Several definitions of good and poor outcome were explored, and developmental, socio-demographic and clinical predictors of outcomes were analysed.

Results

Good clinical outcome varied from 10% to 59%, and good social outcome 15–46%, depending on definition. Poor clinical outcome varied 41–77% and poor social 37–54%. Lack of friends in childhood, father's high social class, lower school performance and earlier age of illness onset predicted poor outcomes.

Discussion

The outcomes of schizophrenia in this study depended on definitions used but were relatively poor. The age of illness onset, father's social class, school performance and poor social contacts in childhood were only statistically significant predictors.

Conclusion

Definitions of outcome have a major effect on estimates for proportions of good and bad outcomes and on the predictors of outcomes. However, regardless of which definitions were used, the outcome of schizophrenia in this population-based sample was generally bleak.

Keywords

SchizophreniaOutcomePredictorsPrognosisEpidemiology
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 2 , March 2007 , pp. 129 - 136
Copyright
Copyright © Elsevier Masson SAS 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, DSM-III-R: Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. revisedWashington: American Psychiatric Association; 1987.Google Scholar
Andreasen, N.C., Carpenter, W.T., Kane, J.M., Lasser, R.A., Marder, S.R., Weinberger, D.R.Remission in schizophrenia: Proposed criteria and rationale for consensus. Am J Psychiatry 2005;162:441–449.CrossRefGoogle ScholarPubMed
Angermeyer, M.C., Kuhn, L., Goldstein, J.M.Gender and the course of schizophrenia: differences in treated outcomes. Schizophr Bull 1990;16:293–307.CrossRefGoogle ScholarPubMed
Angst, J.European long-term follow-up studies of schizophrenia. Schizophr Bull 1988;14:501–513.CrossRefGoogle ScholarPubMed
Cannon-Spoor, H.E., Potkin, S.G., Wyatt, R.J.Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 1982;8:470–484.CrossRefGoogle ScholarPubMed
Goater, N., King, M., Cole, E., Leavey, G., Johnson-Sabine, E., Blizard, R.et al.Ethnicity and outcome of psychosis. Br J Psychiatry 1999;175:34–42.CrossRefGoogle Scholar
Häfner, A., an der Heiden, W.Course and outcome of schizophrenia. In: Hirsch, S.R., Weinberger, D.R.Schizophrenia 2nd edWashington: Blackwell Publishing; 2003. p. 127.Google ScholarPubMed
Harding, C., Brooks, G., Ashikaga, T., Strauss, J., Breier, A.The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later. Am J Psychiatry 1987;144:718–726.Google ScholarPubMed
Harrison, G., Croudace, T., Mason, P., Glazebrook, C., Medley, I.Predicting the long-term outcome of schizophrenia. Psychol Med 1996;26:697–705.CrossRefGoogle ScholarPubMed
Harrison, G., Hopper, K., Craig, T., Laska, E., Siegel, C., Wanderling, J.et al.Recovery from psychotic illness: a 15- and 25-year international follow-up study. Br J Psychiatry 2001;178:506–517.CrossRefGoogle ScholarPubMed
Hegarty, J.D., Baldessarini, R.J., Tohen, M., Waternaux, C., Oepen, G.One hundred years of schizophrenia: A meta-analysis of the outcome literature. Am J Psychiatry 1994;151:1409–1416.Google ScholarPubMed
Hofer, A., Rettenbacher, M.A., Widschwendter, C.G., Kemmler, G., Hummer, M., Fleischhacker, W.W.Correlates of subjective and functional outcomes in outpatient clinic attendees with schizophrenia and schizoaffective disorder. Eur Arch Psychiatry Clin Neurosci 2006;256(4):246–255.CrossRefGoogle ScholarPubMed
Isohanni, M., Oja, H., Moilanen, I., Rantakallio, P., Koiranen, M.The relation between teenage smoking and drinking, with special reference to non-standard family background. Scand J Soc Med 1993;21:24–30.CrossRefGoogle ScholarPubMed
Isohanni, M., Mäkikyrö, T., Moring, J., Räsänen, P., Hakko, H., Partanen, U.et al.A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Soc Psychiatry Psychiatr Epidemiol 1997;32:303–308.CrossRefGoogle Scholar
Isohanni, I., Järvelin, M.-R., Nieminen, P., Jones, P.B., Rantakallio, P., Jokelainen, J.et al.School performance as a predictor of psychiatric hospitalization in adult life. A 28-year follow-up in the northern Finland 1966 birth cohort. Psychol Med 1998;28:967–974.CrossRefGoogle ScholarPubMed
Isohanni, I., Jones, P.B., Järvelin, M.-R., Nieminen, P., Rantakallio, P., Jokelainen, J.et al.Educational consequences of mental disorders treated in hospital. A 31-year follow-up of the Northern Finland 1966 birth cohort. Psychol Med 2001;31:339–349.CrossRefGoogle ScholarPubMed
Jäger, M., Bottlender, R., Strauss, A., Möller, H.-J.Fifteen-year follow-up of ICD-10 schizoaffective disorders compared with schizophrenia and affective disorders. Acta Psychiatr Scand 2004;109:30–37.CrossRefGoogle ScholarPubMed
Jobe, T.H., Harrow, M.Long-term outcome of patients with schizophrenia: A review. Can J Psychiatry 2005;50(14):892–900.CrossRefGoogle ScholarPubMed
Johnstone, E.C., Frith, C.D., Lang, F.H., Owens, D.G.C.Determinants of the extremes of outcome in schizophrenia. Br J Psychiatry 1995;167:604–609.CrossRefGoogle Scholar
Jones, P.B., Rantakallio, P., Hartikainen, A.-L., Isohanni, M., Sipilä, P.Schizophrenia and other psychiatric disorders following pregnancy and delivery complications: A follow-up of the 1966 North Finland birth cohort. Am J Psychiatry 1998;155:355–364.CrossRefGoogle Scholar
Jonsson, H., Nyman, A.K.Predicting long-term outcome in schizophrenia. Acta Psychiatr Scand 1991;83:342–346.CrossRefGoogle Scholar
Kay, S.R., Opler, L.A., Fiszbein, A.Positive and Negative Syndrome Scale (PANSS) American Psychiatric Association. Handbook of psychiatric measures Washington: American Psychiatric Association; 2000.Google Scholar
Kua, J., Wong, K.E., Kua, E.H., Tsoi, W.F.A 20-year follow-up study on schizophrenia in Singapore. Acta Psychiatr Scand 2003;108:2000. p. 118–125.CrossRefGoogle ScholarPubMed
Lauronen, E., Koskinen, J., Veijola, J., Miettunen, J., Jones, P.B., Fenton, W.S.et al.Recovery from schizophrenic psychoses within the Northern Finland 1966 Birth Cohort. J Clin Psychiatry 2005;66:375–383.CrossRefGoogle ScholarPubMed
Leff, J., Sartorius, N., Jablensky, A., Korten, A., Ernberg, A.The International Pilot Study of Schizophrenia: five-year follow-up findings. Psychol Med 1992;22:131–145.CrossRefGoogle ScholarPubMed
Linszen, D.H., Dingemans, P.M., Lenior, M.E.Cannabis abuse and the course of recent-onset schizophrenia disorders. Arch Gen Psychiatry 1994;51(4):273–279.CrossRefGoogle Scholar
Mäki, P., Veijola, J., Rantakallio, P., Jokelainen, J., Jones, P.B., Isohanni, M.Schizophrenia in the offspring of antenatally depressed mothers: a 31-year follow-up of the Northern Finland 1966 Birth Cohort. Schizophr Res 2004;66:79–81.CrossRefGoogle ScholarPubMed
Mäkikyrö, T., Isohanni, M., Moring, J., Oja, H., Hakko, H., Jones, P.et al.Is child's risk of early onset schizophrenia increased in the highest social class?. Schizophr Res 1997;23:245–252.CrossRefGoogle ScholarPubMed
Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., Croudace, T.Association between duration of untreated psychosis and outcome in cohorts of first-episode patients. A systematic review. Arch Gen Psychiatry 2005;62:975–983.CrossRefGoogle ScholarPubMed
McGlashan, T.H.The Chestnut Lodge follow-up study II. Long-term outcome of schizophrenia and affective disorders. Arch Gen Psychiatry 1984;41:586–601.CrossRefGoogle ScholarPubMed
McGlashan, T.H.Predictors of shorter-, medium-, and longer-term outcome in schizophrenia. Am J Psychiatry 1986;143(1):50–55.Google Scholar
McGlashan, T.H.The prediction of outcome in chronic schizophrenia. Arch Gen Psychiatry 1986;43:167–176.CrossRefGoogle ScholarPubMed
McGlashan, T.H.A selective review of recent North American long-term follow-up studies of schizophrenia. Schizophr Bull 1988;14:515–542.CrossRefGoogle ScholarPubMed
Miettunen, J., Lauronen, E., Veijola, J., Koponen, H., Saarento, O., Isohanni, M.Patterns of psychiatric hospitalizations in schizophrenic psychoses within the Northern Finland 1966 Birth Cohort. Nordic J Psychiatry, in press.Google Scholar
Modestin, J., Huber, A., Satirli, E., Malti, T., Hell, D.Long-term course of schizophrenic illness: Bleuler's study reconsidered. Am J Psychiatry 2003;160:2202–2208.CrossRefGoogle ScholarPubMed
Moilanen, I., Rantakallio, P.The single parent family and the child's mental health. Soc Sci Med 1988;27:181–186.CrossRefGoogle ScholarPubMed
Moilanen, K., Veijola, J., Läksy, K., Mäkikyro, T., Miettunen, J., Kantojärvi, L.et al.Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort. Soc Psychiatry Psychiatr Epidemiol 2003;38:305–310.CrossRefGoogle ScholarPubMed
Ram, R., Bromet, E.J., Eaton, W.W., Pato, C., Schwartz, J.E.The natural course of schizophrenia: A review of first-admission studies. Schizophr Bull 1992;18:185–207.CrossRefGoogle ScholarPubMed
Rantakallio, P.Groups at risk in low birth weight infants and perinatal mortality. Acta Paediatr Scand (Suppl) 1969;193:1–71.Google ScholarPubMed
Räsänen, S., Veijola, J., Hakko, H., Joukamaa, M., Isohanni, M.Gender differences in incidence and age at onset of DSM-III-R schizophrenia. Preliminary results of the Northern Finland 1966 birth cohort study. Schizophr Res 1999;37:197–198.Google ScholarPubMed
Robinson, D.G., Woerner, M.G., McMeniman, M., Mendelowitz, A., Bilder, R.M.Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 2004;161:473–479.CrossRefGoogle ScholarPubMed
Ruggeri, M., Lasalvia, A., Tansella, M., Bonetto, C., Abate, M., Thornicroft, G.et al.Heterogeneity of outcomes in schizophrenia. 3-year follow-up of treated prevalent cases. Br J Psychiatry 2004;184:48–57.CrossRefGoogle ScholarPubMed
Salokangas, R.K.Prognostic implications of the sex of schizophrenic patients. Br J Psychiatry 1983;142:145–151.CrossRefGoogle ScholarPubMed
Salokangas, R.K.R.Living situation, social network and outcome in schizophrenia: A five-year prospective follow-up study. Acta Psychiatr Scand 1997;96:459–468.CrossRefGoogle ScholarPubMed
Salokangas, R.K.R., Honkonen, T., Stengård, E., Koivisto, A.M.To be or not to be married - that is the question of quality of life in men with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2001;36:381–390.CrossRefGoogle ScholarPubMed
Spitzer, R.L., Williams, J.B.W., Gibbon, M., First, M.B.Structured clinical interview for DSM-III-R -Patient Edition (SCID-P, 9/1/89 Version). New York, NY: Biometrics Research Department, New York State Psychiatric Institute; 1989.Google Scholar
Spitzer, R.L., Gibbon, M., Endicott, J.Global Assessment Scale (GAS), Global Assessment of Functioning (GAF) scale, Social and Occupational Functioning Assessment Scale (SOFAS). American Psychiatric Association. Handbook of psychiatric measures. Washington: American Psychiatric Association; 2000.Google Scholar
SPSS Inc, SPSS Base 11.0 for Windows User's Guide. Chicago: SPSS; 1999.Google Scholar
Suvisaari, J.M., Haukka, J., Tanskanen, A., Lönnqvist, J.K.Age at onset and outcome in schizophrenia are related to the degree of familial loading. Br J Psychiatry 1998;173:494–500.CrossRefGoogle ScholarPubMed
Verdoux, H., Van Os, J., Sham, P., Jones, P., Gilvarry, K., Murray, R.Does familiality predispose to both emergence and persistence of psychosis? A follow-up study. Br J Psychiatry 1996;168:620–626.CrossRefGoogle ScholarPubMed
Wiersma, D., Nienhuis, F.J., Slooff, C.J., Giel, R.Natural course of schizophrenic disorders: A 15-year followup of a Dutch incidence cohort. Schizophr Bull 1998;24:75–85.CrossRefGoogle ScholarPubMed
Wiersma, D., Wanderling, J., Dragomirecka, E., Ganev, K., Harrison, G., an der Heiden, W.et al.Social disability in schizophrenia: its development and prediction over 15 years in incidence cohorts in six European centres. Psychol Med 2000;30:1155–1167.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.