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Br J Psychiatry. 2010 Jun;196(6):454-9. doi: 10.1192/bjp.bp.109.068577.

Outcome of first-episode schizophrenia in India: longitudinal study of effect of insight and psychopathology.

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  • 1Section of Cognitive Neuropsychiatry, PO Box 68, Institute of Psychiatry, King's College London, Denmark Hill, London SE58AF, UK.

Abstract

BACKGROUND:

Transcultural studies have found lack of insight to be an almost invariable feature of acute and chronic schizophrenia, but its influence on prognosis is unclear.

AIMS:

To investigate the relationship between insight, psychopathology and outcome of first-episode schizophrenia in Vellore, India.

METHOD:

Patients with a DSM-IV diagnosis of schizophrenia (n = 131) were assessed prospectively at baseline and at 6-month and 12-month follow-up. Demographic and clinical measures included insight, psychopathology, duration of untreated psychosis (DUP) and social functioning. Linear and logistic regression was used to measure predictors of outcome.

RESULTS:

Follow-up data were available for 115 patients at 1 year. All achieved remission, half of them with and half without residual symptoms. Changes in psychopathology and insight during the first 6 months and DUP strongly predicted outcome (relapse or functional impairment), controlling for baseline measures.

CONCLUSIONS:

Outcome of schizophrenia in this setting is driven by early symptomatic improvement and is relatively favourable, in line with other studies from low- and middle-income countries. Early improvement in insight might be a useful clinical guide to future outcome. Reduction of DUP should be a target for intervention.

PMID:
20513855
[PubMed - indexed for MEDLINE]
PMCID:
PMC2878819
Free PMC Article
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