Takagi I, Ichimiya Y, Kato T, Mori D
Kawagoe Dojinkai Hospital.
Seishin Shinkeigaku Zasshi. 1995;97(2):89-105.
We had already made a report on outcome of schizophrenia (1986). The patients, 129 typical schizophrenia, were continuously observed over 30 years in the Kawagoe Dojinkai Hospital. Recently, we again evaluated their prognoses according to the same criteria as adopted in the first report, and divided them into the following five groups. [symbol: see text]: completely remitted group (21 persons, 16.3%), [symbol: see text]: almost remitted cases now holding jobs (23 persons, 17.8%), [symbol: see text]: Slightly remitted group showing good adjustment at home or hospital (41 persons, 31.8%), [symbol: see text]: maladjusted cases always showing an unfavorable condition (25 persons, 19.4%), x : incurable cases (19 persons, 14.7%). 1) In the last 8 years, there were 30 persons (23.3% of the whole patients) who showed prognostic changes (10 persons improved, 20 persons worsen). While the second group ([symbol: see text]) has seen fewer persons (12 persons down) than previous study, the third group ([symbol: see text]) has seen more persons (9 persons up). Each three groups, that is, the first two groups ([symbol: see text] + [symbol: see text], 44 persons, 34.1%), the third group ([symbol: see text], 41 persons, 31.8%), and the forth and fifth groups ([symbol: see text] + x, 44 persons, 34.1%) accounted for a third of the whole patients. It is after 32 years on the average (extending from 21 to 50 years) from the onset of illness that they showed prognostic changes. 2) Generally speaking, catatonic patients had favorable prognoses, hebephrenic patients unfavorable ones, and paranoid patients medium ones. But 4 improved persons in the forth and fifth groups were all hebephrenic type. 3) 17 among the 30 persons who showed prognostic changes were unstable type. They took a wave-like course. 4) 27 of all the 129 patients were dead. 25 were dead from disease mentioned below. Malignancy (8 persons), Cerebral vascular disease, Pneumonia and Diabetes (3 persons), Heart-failure (2 persons), Ileus, Myocardial infarction, Hepato-cirrhosis, Gastric ulcer, Tuberculosis and Natural death (1 person). 2 persons committed suicide. 5) Outcome of 45 patients who discontinued our medical therapy became clear as follows. [symbol: see text] + [symbol: see text]: 18 persons (40.0%), [symbol: see text]: 9 persons (20.0%), [symbol: see text] + x : 18 persons (40.0%). A smaller percentage of the patients belongs to the third group ([symbol: see text]) than that of our patients who were continuously followed by us.
我们曾在1986年发表过关于精神分裂症预后的报告。129例典型精神分裂症患者在川越同仁会医院接受了长达30年的持续观察。最近，我们按照与首次报告相同的标准再次评估了他们的预后，并将他们分为以下五组：[符号：见原文]：完全缓解组（21人，占16.3%），[符号：见原文]：目前已缓解且有工作的病例（23人，占17.8%），[符号：见原文]：在家或医院适应良好的轻度缓解组（41人，占31.8%），[符号：见原文]：始终处于不良状态的适应不良病例（25人，占19.4%），x：无法治愈的病例（19人，占14.7%）。1）在过去8年中，有30人（占全部患者的23.3%）出现了预后变化（10人病情改善，20人病情恶化）。与之前的研究相比，第二组（[符号：见原文]）病情改善的人数较少（减少了12人），而第三组（[符号：见原文]）病情改善的人数较多（增加了9人）。前三组，即前两组（[符号：见原文]+[符号：见原文]，44人，占34.1%）、第三组（[符号：见原文]，41人，占31.8%）以及第四组和第五组（[符号：见原文]+x，44人，占34.1%）各占全部患者的三分之一。他们平均在发病32年后（从21岁到50岁）出现了预后变化。2）一般来说，紧张型患者预后良好，青春型患者预后不良，偏执型患者预后中等。但第四组和第五组中的4例病情改善者均为青春型。3）在30例出现预后变化的患者中，有17例为不稳定型。他们呈波浪式病程。4）129例患者中有27例死亡。25例死于以下疾病：恶性肿瘤（8例）、脑血管疾病、肺炎和糖尿病（3例）、心力衰竭（2例）、肠梗阻、心肌梗死、肝硬化、胃溃疡、肺结核以及自然死亡（各1例）。2例自杀身亡。5）45例中断我们治疗的患者的预后情况如下：[符号：见原文]+[符号：见原文]：18例（占40.0%），[符号：见原文]：9例（占20.0%），[符号：见原文]+x：18例（占40.0%）。与我们持续随访的患者相比，属于第三组（[符号：见原文]）的患者比例较小。
