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Prognostic Factors in Schizophrenia

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Schizophrenia can affect anybody, with no class or strata of people being exempt. Doctors, chartered accountants, lawyers, educated and uneducated people, men and women, rich and poor, urban and rural, young and old, can all be afflicted with schizophrenia. Generally, however, schizophrenia begins during adolescence or young adulthood with the age group of 18–30 being highly predisposed. Schizophrenia seems to worsen and become better in cycles with the acute psychotic phase often alternating with residual features such as social withdrawal, blunted emotions and extreme apathy. It is not necessary for family history of schizophrenia to be present in each case, not is it necessary for a stressful event to have preceded the illness.

Prognostic Factors
Factors which are responsible for a good prognostic outcome of schizophrenia are:
  • Age of the patient – Rhe older the patient, the more favorable the prognosis
  • The duration of illness – The shorter the duration prior to treatment, the better the outcome.
  • The rapidity of development of the symptoms – Surprisingly, it has been found that the more speedily the symptoms develop, the faster do they respond to treatment; a very slow, insidious, and gradual onset of illness suggests a final poor outcome.
  • A patient who had close friendships and multiple relationships prior to illness has a brighter chance of recovering than a patient with few or no such relationships.
  • Life stress prior to onset – An episode brought on by a major identifiable life stress will respond more quickly than an episode without any obvious cause.
  • Marital history – A patient with a stable and helpful marital partner has a favorable prognosis as compared to an unmarried patient.
  • Educational history – The higher the level of education, the more are the chance of a patient coming rapidly to terms with the illness and handling the post – illness sequence.
  • Occupational history – A patient with a good stable occupation or business prior to onset of illness will respond better than a patient who is jobless and economically unsound.
  • Family history – An absence of schizophrenia in the family points to a better prognosis.
  • Family's attitude towards the returning patient – hostile behavior by family members, or vice versa, excessive care and attention by them can undermine the patient’s sense of confidence and hamper recovery.
  • Social support systems – A patient with a joint family and a staunch circle of friends who are ready lend a helping hand, is much better off than a lone man afflicted with the illness, whose relatives are in some far off land, and who has no one to turn to.
  • Organic brain damage – Presence of concurrent obvious brain damage (mental retardation, epilepsy, head injury etc.) hinders the final adequate recovery from schizophrenia.

5

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  • Prognostic Factors in Schizophrenia
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