The natural course of schizophrenia: A review of first-admission studies

Ranganathan Ram, Evelyn J. Bromet, William W. Eaton, Carlos Pato, Joseph E. Schwartz

Research output: Contribution to journalArticlepeer-review

154 Scopus citations


In this article, research on the natural course of illness among first-admission schizophrenic patients is reviewed from an epidemiological perspective. Three types of studies are considered: statistical reports dating primarily from the preneuroleptic era; long-term followback studies; and more recent prospectively designed cohort studies. Although relatively more first-admission patients have a positive course than do multiple admissions patients, the findings confirm the substantial heterogeneity in course and outcome. Methodological improvements in first-admission research are suggested, including separating the analyses of first-episode patients from those with past psychotic experiences; employing longitudinal methods for deriving diagnosis; including patients with drug and alcohol problems where appropriate; enlarging the samples either by multisite or multicenter collaborations or by pooling data across studies; and obtaining better data on treatment experiences in naturalistic research.

Original languageEnglish (US)
Pages (from-to)185-207
Number of pages23
JournalSchizophrenia bulletin
Issue number2
StatePublished - 1992

ASJC Scopus subject areas

  • Psychiatry and Mental health


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