mental health disorders
Schizophrenia
Prognosis for Schizophrenia
Early detection and early treatment have become the guiding principles for managing schizophrenia. The sooner treatment is started, the better the outcome. For people with schizophrenia, the prognosis depends largely on adherence to drug treatment. Without drug treatment, 70 to 80% of people have another episode within the first year after diagnosis. Drugs taken continuously can reduce this percentage to about 30% and can lessen the severity of symptoms significantly in most people. After discharge from a hospital, people who do not take prescribed drugs are very likely to be readmitted within the year. Taking drugs as directed dramatically reduces the likelihood of being readmitted. Despite the proven benefit of drug therapy, half of people with schizophrenia do not take their prescribed drugs. Some do not recognize their illness and resist taking drugs. Others stop taking their drugs because of unpleasant side effects. Memory problems, disorganization, or simply a lack of money prevents others from taking their drugs. Adherence is most likely to improve when specific barriers are addressed. If side effects of drugs are a major problem, a change to a different drug may help. A consistent, trusting relationship with a doctor or other therapist helps some people with schizophrenia to accept their illness more readily and recognize the need for adhering to prescribed treatment. Over longer periods, the prognosis varies, roughly as follows: One third of people achieve significant and lasting improvement. One third achieve some improvement with intermittent relapses and residual disabilities. One third experience severe and permanent incapacity. Only about 15% of all people with schizophrenia are able to function as well as they could before schizophrenia developed. Factors associated with a better prognosisinclude the following: Sudden onset of symptoms Older age when symptoms start A good level of skills and accomplishments before becoming ill Only slight cognitive impairment Presence of only a few negative symptoms (such as reduced expression of emotions) A shorter time between the first psychotic episode and treatment Factors associated with a poor prognosisinclude the following: Younger age when symptoms start Problems functioning in social situations and at work before becoming ill A family history of schizophrenia Presence of many negative symptoms A longer time between the first psychotic episode and treatment Men have a poorer prognosis than women. Women respond better to treatment with antipsychotic drugs. 