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Predicting the Outcome of a Schizophrenic Episode

ROBERT G. WALKER, Ph.D.; FRANCIS E. KELLEY, M.S.S.W.
AMA Arch Gen Psychiatry. 1960;2(5):492-503. doi:10.1001/archpsyc.1960.03590110016002.
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In 1911, Bleuler described schizophrenia as a psychiatric disorder which is “at times chronic, at times marked by intermittent attacks, and which can stop or enter remission at any stage.”1 The widely varying outcomes outlined by Bleuler have been paralleled over the years by similarly varied and inconclusive findings emanating from numerous studies on prognosis in schizophrenia.2-6 A comparatively recent survey of 15 eminent European psychiatrists revealed that in respect to prognosis in schizophrenia “the only definite conclusion reached was that there was little agreement at all.”1

For some time, however, there has been fairly good agreement as to the major difficulties involved in studying prognosis in schizophrenia. First, there is imperfect agreement in regard to the fundamental problem of diagnosis. Psychiatrists vary as to the criteria which they believe must be met in order to establish a diagnosis of schizophrenia. Part

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