Prospective Prediction Of Schizophrenic Remission

Although numerous studies of prognosis in schizophrenia exist, most have been biased by retrospective design and limited by short follow-up. There is no well-documented method for predicting on admission the longterm clinical course of schizophrenics. However, there are three studies 3,10,13 that have been well-enough designed to merit clinical confidence. Wittman used her Elgin Prognostic Scale¹³prospectively and in 83% of cases correctly predicted clinical course in schizophrenia. Her studies suffered from a follow-up period of only a year, and although her scale proved reliable in her own hands, it has proved unwieldy and subjective (21 weighted items) in the hands of subsequent investigators. Stephens and Astrup¹⁰examined 178 admission charts and decided which patients represented "process" and "non-process" (remitting) schizophrenia. They were able to obtain 5-13 year follow-ups on 80% of these patients. Ten per cent of the "recovered" and