Sustained remission in drug-free schizophrenic patients.

The inability to determine which schizophrenic patients do not require maintenance medication is a significant gap in current knowledge. This report describes 23 largely chronic DSM-III schizophrenic patients who, after a period of inpatient treatment, sustained good outcome without maintenance antipsychotic medication over an average of 15 years. Retrospective study of these patients revealed that their distinguishing characteristics at admission included better premorbid social and occupational adjustment, higher levels of accrued psychosocial competence and acquired skills, fewer hebephrenic traits, and the preservation of affect (depressed mood). Hence, even within a largely chronic patient sample, classic predictors of good outcome may also be useful in predicting sustained remission without medication.