Schizophrenic thought disorder at follow-up. A persistent or episodic course?

This follow-up investigation examined the course of thought disorder in early, young schizophrenic, other psychotic, and nonpsychotic patients. Patients were assessed for the severity of thought disorder at index hospitalization and at two and four years after hospital discharge. Follow-up evaluations included assessments of adjustment and short-term outcome. Schizophrenic patients showed more thought disorder than nonschizophrenic patients at all three periods. Almost 40% (16/41) of the schizophrenic patients exhibited persistent thought disorder symptoms after the acute phase and an additional 37% (15/41) showed an episodic thought disorder course. Across diagnoses, patients who were thought disordered at both follow-ups demonstrated higher rates of unemployment and rehospitalization than did patients in non-thought-disordered and episodic thought disorder groups. To date, 25% (16/65) of psychotic nonschizophrenic patients showed persistent thought disorder courses similar to schizophrenia, while another 40% (24/65) showed remitting thought disorder symptoms more common to nonpsychotic patients.