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After the chronicity of schizophrenia was found to be lower on the island of Mauritius, where the population is of Indian and African origin, than in a comparable British sample, the question arose of whether this could have been predicted through the use of established prognostic indicators such as those used for distinguishing process and non process schizophrenia. The admission data for 215 psychotic patients ages 15 to 44 in 1956 were therefore searched for such indicators, and the results were compared with outcome ratings obtained 12 years later. For the small Moslem Indian sample, a reasonably good association with outcome was obtained, but for the larger Hindu and non-Indian groups, the results were scarcely better than chance. Manic-depressive features and confusion were not associated with recovery; flatness of affect was associated with chronicity only to a modest extent; acute onset had some favorable significance in the Indians but not in the others; and only the absence of a clear work history gave something like the expected result. It is argued that this comparative failure is due not to poor data but to variance of prognostic indicators with social setting, an argument which is supported by the discovery that two features considered in the West to have no prognostic significance, namely pyschosomatic symptoms and somatic disease, did have quite a strong association with chronicity in two of the three Mauritius peoples. It is suggested that assumptions regarding the relation of certain features to primary process schizophrenia may be based on studies done in too uniform a social setting and that these now need to be tested in non-Western societies.
Raman et al. (Sat,) studied this question.