Menezes P R, Rodrigues L C, Mann A H
Section of Epidemiology and General Practice, Institute of Psychiatry, London, UK.
Eur Arch Psychiatry Clin Neurosci. 1997;247(3):137-45. doi: 10.1007/BF03033067.
A prospective cohort study of schizophrenia was carried out in Sao Paulo, Brazil, in order to investigate clinical and social outcomes in schizophrenia and related psychoses after hospitalization. A sample of 124 individuals who were living in a defined catchment area and had been consecutively admitted to psychiatric hospitals in that area with clinical diagnoses of non-affective functional psychoses was followed up for 2 years. Assessments of clinical status and social adjustment at inclusion and at 2-year follow-up were carried out by means of standardized instruments, the PSE and the DAS. At the end of the follow-up period, 120 subjects (96.8%) were traced, and 103 (83.1%) were re-assessed. At the second assessment, the proportion of subjects with a nuclear syndrome of schizophrenia had halved (from 68.3% to 32.7%), 23.8% were symptom free and 60.2% showed at least one psychotic symptom. Presence of psychotic symptoms at follow-up was best predicted by educational level (less than 4 years of formal education) and an initial DSM-III-R diagnosis of schizophrenia. The distribution of global social adjustment levels at 2-year follow-up was similar to that observed at the outset, with approximately one third of subjects showing good, one third showing intermediate and one third showing poor global social adjustment. Social disability was best predicted by longer duration of illness, worse social adjustment levels at inclusion and lower educational level.
在巴西圣保罗开展了一项针对精神分裂症的前瞻性队列研究，以调查住院后精神分裂症及相关精神病的临床和社会结局。对居住在特定集水区、连续入住该地区精神病医院且临床诊断为非情感性功能性精神病的124名个体进行了为期2年的随访。通过标准化工具PSE和DAS对入组时和2年随访时的临床状况和社会适应情况进行评估。随访期结束时，追踪到了120名受试者（96.8%），其中103名（83.1%）接受了重新评估。在第二次评估时，患有精神分裂症核心综合征的受试者比例减半（从68.3%降至32.7%），23.8%的受试者无症状，60.2%的受试者至少有一项精神病性症状。随访时精神病性症状的出现最能通过教育水平（正规教育年限少于4年）和最初的DSM-III-R精神分裂症诊断来预测。2年随访时总体社会适应水平的分布与开始时观察到的情况相似，约三分之一的受试者表现良好，三分之一表现中等，三分之一表现较差。疾病持续时间更长、入组时社会适应水平更差以及教育水平更低最能预测社会残疾情况。
