Stephens J H
Schizophr Bull. 1978;4(1):25-47. doi: 10.1093/schbul/4.1.25.
The long-term course or natural history of schizophrenia is correlated with differing diagnostic criteria and commonly agreed upon prognostic variables. A review of 38 long-term followup studies of hospitalized schizophrenics reveals that unspecified or Kraepelinian-type schizophrenia has a much worse prognosis than atypical schizophrenia, schizoaffective psychosis, reactive psychosis, or other good premorbid types. Diagnoses based on longitudinal as well as cross-reactional data are more predictive of outcome than cross-sectionally based diagnoses. Drug and psychosocial treatment results must be evaluated in terms of prognostic variables, many of which are incorporated in some currently employed diagnostic criteria. There is no firm evidence that maintenance medication is indicated in some good prognosis patients. The paucity of long-range followups, the inadequacies of outcome assessments, and diagnostic disagreements limit our understanding of the effects of drug treatment, a treatment which is not without dangerous neurological side effects in many patients.
精神分裂症的长期病程或自然史与不同的诊断标准以及普遍认可的预后变量相关。对38项住院精神分裂症患者的长期随访研究进行的综述显示，未明确分类或克雷佩林型精神分裂症的预后比非典型精神分裂症、分裂情感性精神病、反应性精神病或其他病前状态良好的类型要差得多。基于纵向以及交叉反应数据的诊断比基于横断面数据的诊断对结局更具预测性。药物和心理社会治疗结果必须根据预后变量进行评估，其中许多变量已纳入一些当前使用的诊断标准中。没有确凿证据表明某些预后良好的患者需要维持用药。长期随访的缺乏、结局评估的不足以及诊断分歧限制了我们对药物治疗效果的理解，而药物治疗在许多患者中并非没有危险的神经副作用。
