Heterogeneity of outcomes of schizophrenia: 3 year follow-up for treated prevalent cases.

BACKGROUND: Care for people with schizophrenia should address a wide range of outcomes, including professional and consumer perspectives. AIMS: To measure changes in psychopathology, functioning, needs for care and quality of life; to develop predictive models for each outcome domain; and to assess the frequency of 'good'and'poor' outcomes, as defined in a series of different definitions that use combinations of the four domains measured. METHOD:Three-year follow-up of a 1-year-treated prevalence cohort of 107 patients with an ICD-10 diagnosis of schizophrenia attending the South Verona community-based mental health service. RESULTS: Mean symptom severity and some types of needs for care worsen, but quality of life shows no change. Functioning shows a non-significant trend to deteriorate. Between 32% and 42% of the variance in the four key outcomes was explained by our model. Different definitions of 'good'and 'poor' outcome included 0-31% of patients, depending on the definition used. CONCLUSIONS: The 3-year outcome for schizophrenia depends on the domain of outcome used, whether staff or patient ratings are used and the stringency of the definitions used for good and poor outcome.