Pfohl B, Winokur G
J Nerv Ment Dis. 1983 May;171(5):296-300. doi: 10.1097/00005053-198305000-00006.
All hospital records, interviews, and notes are reviewed on a group of 52 chronic hebephrenic/catatonic schizophrenics who were institutionalized before the era of antipsychotic medications. The authors catalog the presence or absence of individual symptoms of schizophrenia on a year by year basis over a span of 25 years and present this data in a series of bar graphs. Symptoms such as avolition, impaired social interaction, and flat affect become more frequent over the 25 years of follow-up. Hallucinations and delusions become less frequent. Eighteen of the patients are noted to have had a DSM-III personality disorder premorbidly and eight of these are characterized as schizoid personality disorder. Level of insight is found to be poor at the onset of schizophrenia and deteriorates further over the next 5 years. Although the study design contains a sampling bias in favor of chronically institutionalized cases, several lines of evidence suggest that the trends reported here are not artifacts of institutionalization but are due to schizophrenia.
对一组52例慢性青春型/紧张型精神分裂症患者的所有医院记录、访谈和笔记进行了回顾，这些患者在抗精神病药物时代之前就已被收容住院。作者逐年记录了25年间这些患者精神分裂症各个症状的出现或缺失情况，并将这些数据呈现在一系列柱状图中。在25年的随访中，诸如意志缺乏、社交互动受损和情感平淡等症状变得更加频繁。幻觉和妄想则变得不那么频繁。其中18例患者病前被诊断为DSM-III人格障碍，其中8例被归类为分裂样人格障碍。研究发现，精神分裂症发病时洞察力水平较差，且在接下来的5年中进一步恶化。尽管该研究设计存在偏向长期住院病例的抽样偏差，但多条证据表明，这里报告的趋势并非住院造成的假象，而是由精神分裂症导致的。
