Relapse in schizophrenia: a review of the concept and its definitions

Relapse in schizophrenia: a review of the concept and its definitions 1 The increasingly rigorous attention paid to the diagnosis of schizophrenia has not yet been extended to the development of reliable and valid criteria for describing the course of the illness. Over the past two decades the concept of 'relapse' has become the pre-eminent measure of the success of community treatment programmes of schizophrenia. However, to date there has been little effort to examine this measure critically, or to develop other measures to reflect the wide range of clinical outcome in schizophrenia. This issue is not new. Kraepelin has been faulted for his lack of clarity in discussing the association between the diagnosis of dementia praecox and a poor clinical outcome (WHO, 1975). Stressing that 'the general course of dementia praecox is very variable', he outlined several typical courses of the illness, all of which proceeded to terminal dementia He recognized the lack of specifically defined outcome criteria, citing reports showing recovery rates varying from 0 to 25%.