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Prospective Prediction Of Schizophrenic Remission

GEORGE E. VAILLANT, MD
Arch Gen Psychiatry. 1964;11(5):509-518. doi:10.1001/archpsyc.1964.01720290051007.
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Although numerous studies of prognosis in schizophrenia exist, most have been biased by retrospective design and limited by short follow-up. There is no well-documented method for predicting on admission the longterm clinical course of schizophrenics. However, there are three studies 3,10,13 that have been well-enough designed to merit clinical confidence.

Wittman used her Elgin Prognostic Scale13 prospectively and in 83% of cases correctly predicted clinical course in schizophrenia. Her studies suffered from a follow-up period of only a year, and although her scale proved reliable in her own hands, it has proved unwieldy and subjective (21 weighted items) in the hands of subsequent investigators.

Stephens and Astrup10 examined 178 admission charts and decided which patients represented "process" and "non-process" (remitting) schizophrenia. They were able to obtain 5-13 year follow-ups on 80% of these patients. Ten per cent of the "recovered" and

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