The research question of which mediating factors influence the long-term course of schizophrenia was not asked until recently because the expectation has been of uniformly poor outcome (Kraepelin, 1902; American Psychiatric Association, 1980). However, anecdotal clinical knowledge about heterogeneity in the long-term course of this severe illness has been firmly supported in the last 15 years by six recent longitudinal studies in Europe, Asia, and the USA (Blueler, 1972; Ciompi & Müller, 1976; Huber et al, 1979; Tsuang et al, 1979; Harding et al, 19876; Ogawa et al, 1987). Each of these studies, more methodologically rigorous than those of the past, has found multiple indices of wide heterogeneity in the long-term outcome of schizophrenia with trends toward significant improvement or recovery demonstrated in over half of each cohort.