Prognosis of schizophrenia

See also: Physical health in schizophrenia and Schizophrenia and smoking
Main article: Schizophrenia
John Nash, a US mathematician, began showing signs of paranoid schizophrenia during his college years. Despite having stopped taking his prescribed medication, Nash continued his studies and was awarded the Nobel Prize in 1994. His life was depicted in the 2001 film A Beautiful Mind.

The prognosis of schizophrenia is varied at the individual level. In general it has great human and economics costs.[1] It results in a decreased life expectancy of 12–15 years primarily due to its association with obesity, little exercise, and smoking, while an increased rate of suicide plays a lesser role.[1] These differences in life expectancy increased between the 1970s and 1990s,[2] and between the 1990s and 2000s. This difference has not substantially changed in Finland for example – where there is a health system with open access to care.[3]

Schizophrenia is a major cause of disability. Approximately three quarters of people with schizophrenia have ongoing disability with relapses.[4] Still some people do recover completely and additional numbers function well in society.[5][6]

Most people with schizophrenia live independently with community support.[1] In people with a first episode of psychosis a good long-term outcome occurs in 42% of cases, an intermediate outcome in 35% of cases, and a poor outcome in 27% of cases.[7] Outcome for schizophrenia appear better in the developing than the developed world.[8] These conclusions however have been questioned.[9][10]

There is a higher than average suicide rate associated with schizophrenia. This has been cited at 10%, but a more recent analysis of studies and statistics places the estimate at 4.9%, most often occurring in the period following onset or first hospital admission.[11] Several times more attempt suicide.[12] There are a variety of reasons and risk factors.[13][14]

  1. ^ a b c van Os J, Kapur S (August 2009). "Schizophrenia". Lancet. 374 (9690): 635–645. doi:10.1016/S0140-6736(09)60995-8. PMID 19700006. S2CID 208792724.
  2. ^ Saha S, Chant D, McGrath J (October 2007). "A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time?". Archives of General Psychiatry. 64 (10): 1123–1131. doi:10.1001/archpsyc.64.10.1123. PMID 17909124. S2CID 25293616.
  3. ^ Chwastiak LA, Tek C (August 2009). "The unchanging mortality gap for people with schizophrenia". Lancet. 374 (9690): 590–592. doi:10.1016/S0140-6736(09)61072-2. PMID 19595448. S2CID 8785405.
  4. ^ Smith T, Weston C, Lieberman J (August 2010). "Schizophrenia (maintenance treatment)". American Family Physician. 82 (4): 338–339. PMID 20704164.
  5. ^ Warner R (July 2009). "Recovery from schizophrenia and the recovery model". Current Opinion in Psychiatry. 22 (4): 374–380. doi:10.1097/YCO.0b013e32832c920b. PMID 19417668. S2CID 26666000.
  6. ^ Helman DS (November 2016). "Schizophrenia Is Normal: My Journey Through Diagnosis, Treatment, and Recovery". Schizophrenia Bulletin. 42 (6): 1309–1311. doi:10.1093/schbul/sbu131. PMC 5049512. PMID 25181987.
  7. ^ Menezes NM, Arenovich T, Zipursky RB (October 2006). "A systematic review of longitudinal outcome studies of first-episode psychosis". Psychological Medicine. 36 (10): 1349–1362. doi:10.1017/S0033291706007951. PMID 16756689. S2CID 23475454.
  8. ^ Isaac M, Chand P, Murthy P (August 2007). "Schizophrenia outcome measures in the wider international community". The British Journal of Psychiatry. Supplement. 50: s71–s77. doi:10.1192/bjp.191.50.s71. PMID 18019048. S2CID 3058475.
  9. ^ Cohen A, Patel V, Thara R, Gureje O (March 2008). "Questioning an axiom: better prognosis for schizophrenia in the developing world?". Schizophrenia Bulletin. 34 (2): 229–244. doi:10.1093/schbul/sbm105. PMC 2632419. PMID 17905787.
  10. ^ Burns J (August 2009). "Dispelling a myth: developing world poverty, inequality, violence and social fragmentation are not good for outcome in schizophrenia". African Journal of Psychiatry. 12 (3): 200–205. doi:10.4314/ajpsy.v12i3.48494. PMID 19894340.
  11. ^ Palmer BA, Pankratz VS, Bostwick JM (March 2005). "The lifetime risk of suicide in schizophrenia: a reexamination". Archives of General Psychiatry. 62 (3): 247–253. doi:10.1001/archpsyc.62.3.247. PMID 15753237.
  12. ^ Radomsky ED, Haas GL, Mann JJ, Sweeney JA (October 1999). "Suicidal behavior in patients with schizophrenia and other psychotic disorders". The American Journal of Psychiatry. 156 (10): 1590–1595. doi:10.1176/ajp.156.10.1590. PMID 10518171.
  13. ^ Caldwell CB, Gottesman II (1990). "Schizophrenics kill themselves too: a review of risk factors for suicide". Schizophrenia Bulletin. 16 (4): 571–589. doi:10.1093/schbul/16.4.571. PMID 2077636.
  14. ^ Dalby JT, Williams RJ (1989). Depression in schizophrenics. New York: Plenum Press. ISBN 0-306-43240-4.