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Seventeen-year clinical outcome of schizophrenia in Bali

Published online by Cambridge University Press:  16 April 2020

T. Kurihara ,
M. Kato ,
R. Reverger  and
I.G.R. Tirta
T. Kurihara*
Affiliation:
Department of Psychiatry, Komagino Hospital, 273 Uratakao, Hachioji, Tokyo 193-8505, Japan
M. Kato
Affiliation:
Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku, Tokyo 160-8582, Japan
R. Reverger
Affiliation:
Department of Psychiatry, University of Udayana, Badung, Bali, Indonesia
I.G.R. Tirta
Affiliation:
Bangli Mental Hospital, Jl. Kusuma Yuda 29, Bangli, Bali, Indonesia
*
*Corresponding author. Tel.: +81 42 663 2222; fax: +81 42 663 3286. E-mail address: kurihara@sj8.so-net.ne.jp (T. Kurihara).
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Abstract

Objective

To examine the 17-year clinical outcome of schizophrenia and its predictors in Bali.

Methods

Subjects were 59 consecutively admitted first-episode schizophrenia patients. Their clinical outcome was evaluated by standardized symptomatic remission criteria based on Positive and Negative Syndrome Scale (PANSS) scores and operational functional remission criteria at 17-year follow-up. The standardized mortality ratio (SMR) over 17 years was also calculated as another index of clinical outcome.

Results

Among these 59 patients, 43 (72.9%) could be followed-up, 15 (25.4%) had died, and one (1.7%) was alive but refused to participate in the study. Combined remission (i.e. symptomatic and functional remission) was achieved in 14 patients (23.7% of original sample). Duration of untreated psychosis (DUP) was a significant baseline predictor of combined remission. Mean age at death of deceased subjects was 35.7, and SMR was 4.85 (95% CI: 2.4–7.3), indicating that deaths were premature. Longer DUP was associated with excess mortality.

Conclusions

The long-term outcome of schizophrenia in Bali was heterogeneous, demonstrating that a quarter achieved combined remission, half were in nonremission, and a quarter had died at 17-year follow-up. DUP was a significant predictor both for combined remission and mortality.

Keywords

First-episode psychosisOutcome assessmentDeveloping countries
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 5 , August 2011 , pp. 333 - 338
Copyright
Copyright © Elsevier Masson SAS 2011

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