Factors affecting the prognosis of schizophrenia

  There are three outcomes for schizophrenia: 1. complete remission with treatment; 2. partial control of symptoms with some residual symptoms and partial impairment of social functioning with treatment; and 3. deterioration of the condition with the patient heading toward decline and psychiatric disability.  With or without a positive family history of mental illness, the prognosis of those with a positive family history is relatively poor.  The prognosis of those with acute onset is better than that of those with chronic onset.  The prognosis of those with short duration of illness is better than that of patients with longer duration of illness. Early detection, early diagnosis and early treatment is one of the important factors affecting the prognosis.  The prognosis is better for first-episode patients than for those with recurrent episodes. It is generally accepted that patients with schizophrenia need to adhere to medication for 2 years at first onset, 5 years at second onset, and possibly longer or even lifelong medication at third and more than third onset.  In terms of schizophrenia subtypes, the prognosis is better for the paranoid and catatonic types and the worst for the simple types. This is due to the fact that the more positive symptoms there are, the better the prognosis, while the simple type has mainly negative symptoms and therefore has the worst prognosis.  The younger the age of onset, the worse the prognosis, and the later the age of onset, the better the prognosis.  In terms of treatment, patients with good compliance with medication are better than those with poor compliance.  The prognosis of patients with relatively intact personality before the disease was better than those with significant personality defects before the disease.  The prognosis of those with intact marriages was better than that of those with broken families and celibates.  The prognosis of those with good social relationships and regular workers was better than those without regular jobs and good social relationships.