Fenton W S, McGlashan T H
Chestnut Lodge Research Institute, Rockville 20850.
Am J Psychiatry. 1987 Oct;144(10):1306-9. doi: 10.1176/ajp.144.10.1306.
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.
无法确定哪些精神分裂症患者不需要维持药物治疗是当前知识领域的一个重大空白。本报告描述了23名主要为慢性病程的DSM-III精神分裂症患者，他们在经过一段时间的住院治疗后，在平均15年的时间里未使用抗精神病药物维持治疗却保持了良好的预后。对这些患者的回顾性研究表明，他们入院时的显著特征包括病前社会和职业适应更好、积累的心理社会能力和习得技能水平更高、青春型特征较少以及情感（抑郁情绪）得以保留。因此，即使在主要为慢性病程的患者样本中，良好预后的经典预测因素在预测无需药物治疗的持续缓解方面可能也有用。
