Prognostic Variables at Intake and Long-Term Level of Function in Schizophrenia

Abstract

Objective: This study assessed the rela- tionship between symptoms and cogni- tive measures at intake and functional outcome 2-8 years later (average 3 years) in first-episode and previously treated schizophrenia patients. Method: A composite cognitive score was assessed at intake to determine the influence of cognition on later functional outcome. At intake and follow-up, posi- tive and negative symptoms were as- sessed with the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms, and affective symptoms were assessed with the Hamilton Depression Rating Scale. Level of function in seven domains (social function, occupational function, independent living, symptom severity, fullness of life, extent of psychiatric hospi- talization, and overall level of function) at intake and follow-up was assessed with the Strauss-Carpenter Level of Function scale. The contributions of sex, education, and duration of illness to functional out- come were also examined. Results: The results indicated that symp- toms at intake had distinct patterns of prognostic significance for functional out- come in previously treated patients, com- pared with first-episode patients. In addi- tion, male and female patients differed in the degree to which initial symptoms were correlated with later function. Conclusions: Initial level of function, symptoms, sex, education, and duration of illness are all important predictors for functional outcome in patients with schizophrenia.