The influence of neuroleptics on specific syndromes and symptoms in schizophrenics with unfavourable long-term course. A 5-year follow-up study of 50 chronic schizophrenics.

Fifty chronic schizophrenics with severe residual psychopathology were followed up over a 5-year period. All of them had continuously received neuroleptics for many years before and throughout the period of investigation. In 60% (n = 30) of the patients positive symptoms which were unchanged in quality and severity were present throughout the period of investigation. In 28% (n = 14) of the patients marked positive symptoms persisted from the very beginning up to 1990 (in every case more than 20 years). Applying Leonhard's classification it was obvious that syndromes are roughly unchanged with respect to the preneuroleptic era. In these patients neuroleptics seemed to have only unspecific suppressing effects on affectivity. It is supposed that in schizophrenia which leads to severe residual psychopathology, Leonhard's classification is superior to the positive-negative distinction and is a promising concept for future research in etiology and therapy.