The prognosis of schizophrenia : A systematic review and meta-analysis with meta-regression of 20-year follow-up studies
(2022) In Schizophrenia Research 250. p.152-163- Abstract
Objective: The aim was to examine the general outcome of schizophrenia after 20 years or more. Methods: Using the PRISMA guidelines, we conducted a systematic review and meta-analysis with meta-regression on long-term follow-up studies of schizophrenia up until April 21, 2021. We included prospective studies with at least 20 years of follow-up on patients with a diagnosis of schizophrenia, and the studies had to include face-to-face clinical evaluation. We examined outcome in three nested groups: ‘recovery’, ‘good or better’ (including also ‘recovery’), and ‘moderate or better’ (including also ‘recovery’ and ‘good or better’). We used random-effects meta-analysis and meta-regression to examine mean estimates and possible moderators.... (More)
Objective: The aim was to examine the general outcome of schizophrenia after 20 years or more. Methods: Using the PRISMA guidelines, we conducted a systematic review and meta-analysis with meta-regression on long-term follow-up studies of schizophrenia up until April 21, 2021. We included prospective studies with at least 20 years of follow-up on patients with a diagnosis of schizophrenia, and the studies had to include face-to-face clinical evaluation. We examined outcome in three nested groups: ‘recovery’, ‘good or better’ (including also ‘recovery’), and ‘moderate or better’ (including also ‘recovery’ and ‘good or better’). We used random-effects meta-analysis and meta-regression to examine mean estimates and possible moderators. Results: We identified 1089 records, which were screened by two independent researchers. 14 prospective studies (1991 patients) published between 1978 and 2020 were found eligible. The studies used a range of different scales and definitions for outcome, and some used the same definitions for different outcomes. To compare outcome across studies, we designed and applied a unified template for outcome definitions and cutoffs, based on earlier studies' recommendations. Our meta-analysis found that 24.2 % had ‘recovered’ (n = 246, CI: 20.3–28.0 %), 35.5 % had a ‘good or better’ outcome (n = 766, CI: 26.0–45.0%), and 59.7% had ‘moderate or better’ outcome (n = 1139, CI: 49.3–70.1 %). Conclusions: The results contribute to debunk the myth that schizophrenia inevitably has a deteriorating course. Recovery is certainly possible. Schizophrenia remains, however, a severe and complex mental disorder, exhibiting a limited change in prognosis despite >100 years of research and efforts to improve treatment.
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- author
- Molstrom, Ida Marie ; Nordgaard, Julie ; Urfer-Parnas, Annick ; Handest, Rasmus ; Berge, Jonas LU and Henriksen, Mads Gram
- organization
- publishing date
- 2022-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Longitudinal, Outcome, Psychosis, Recovery, Schizophreniform
- in
- Schizophrenia Research
- volume
- 250
- pages
- 12 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85142428141
- pmid:36417817
- ISSN
- 0920-9964
- DOI
- 10.1016/j.schres.2022.11.010
- language
- English
- LU publication?
- yes
- id
- 188b1fba-39f3-43f1-ac61-cdbacc5195ff
- date added to LUP
- 2022-12-27 10:19:41
- date last changed
- 2024-06-15 00:49:13
@article{188b1fba-39f3-43f1-ac61-cdbacc5195ff,
abstract = {{<p>Objective: The aim was to examine the general outcome of schizophrenia after 20 years or more. Methods: Using the PRISMA guidelines, we conducted a systematic review and meta-analysis with meta-regression on long-term follow-up studies of schizophrenia up until April 21, 2021. We included prospective studies with at least 20 years of follow-up on patients with a diagnosis of schizophrenia, and the studies had to include face-to-face clinical evaluation. We examined outcome in three nested groups: ‘recovery’, ‘good or better’ (including also ‘recovery’), and ‘moderate or better’ (including also ‘recovery’ and ‘good or better’). We used random-effects meta-analysis and meta-regression to examine mean estimates and possible moderators. Results: We identified 1089 records, which were screened by two independent researchers. 14 prospective studies (1991 patients) published between 1978 and 2020 were found eligible. The studies used a range of different scales and definitions for outcome, and some used the same definitions for different outcomes. To compare outcome across studies, we designed and applied a unified template for outcome definitions and cutoffs, based on earlier studies' recommendations. Our meta-analysis found that 24.2 % had ‘recovered’ (n = 246, CI: 20.3–28.0 %), 35.5 % had a ‘good or better’ outcome (n = 766, CI: 26.0–45.0%), and 59.7% had ‘moderate or better’ outcome (n = 1139, CI: 49.3–70.1 %). Conclusions: The results contribute to debunk the myth that schizophrenia inevitably has a deteriorating course. Recovery is certainly possible. Schizophrenia remains, however, a severe and complex mental disorder, exhibiting a limited change in prognosis despite >100 years of research and efforts to improve treatment.</p>}},
author = {{Molstrom, Ida Marie and Nordgaard, Julie and Urfer-Parnas, Annick and Handest, Rasmus and Berge, Jonas and Henriksen, Mads Gram}},
issn = {{0920-9964}},
keywords = {{Longitudinal; Outcome; Psychosis; Recovery; Schizophreniform}},
language = {{eng}},
pages = {{152--163}},
publisher = {{Elsevier}},
series = {{Schizophrenia Research}},
title = {{The prognosis of schizophrenia : A systematic review and meta-analysis with meta-regression of 20-year follow-up studies}},
url = {{http://dx.doi.org/10.1016/j.schres.2022.11.010}},
doi = {{10.1016/j.schres.2022.11.010}},
volume = {{250}},
year = {{2022}},
}