The goal is to further our knowledge about schizophrenia and other major psychoses by a prospective longitudinal investigation, addressing the following major hypotheses about thought disorder, psychosis, negative symptoms, prognosis, functioning and adjustment over time in schizophrenia: Hypothesis 1: Positive thought disorder and/or psychosis are persisting features for most schizophrenics. The hypothesis runs counter to recent proposals that schizophrenia is a vulnerability to episodes, and is not a continuous disorder. Hypothesis 2: Schizophrenics with persisting positive thought disorder are nuclear schizophrenics with poor clinical courses and downhill life adjustment. Hypothesis 3: Negative symptoms are as predictive as positive symptoms of poor outcome in schizophrenia. Hypothesis 4: Psychosis persists or recurs over time in schizophrenia, but remits in other psychotic disorders. Hypothesis 5: Contrary to recent hypotheses, modern-day schizophrenics still have relatively poor outcomes. Schizophrenics are vulnerable to a sustained disorder and not just to intermittent episodes. The research involves a multifaceted prospective, longitudinal investigation of thought disorders, psychotic symptoms, negative symptoms, and major components of adjustment over time, using a battery of structured interviews, performance tests, thought disorder measures, and behavioral ratings. A large sample of early young, schizophrenic, schizoaffective, manic, and nonpsychotic patients are being assessed longitudinally. Patients have been evaluated at the acute phase, during partial recovery, and are being followed up at various phases during the posthospital period, for disordered thinking, psychotic symptoms, and negative symptoms. They also are being assessed for neurotic and affective symptoms, rehospitalization, and social and work adjustment. The data are used to evaluate a number of theories about thought disorder, psychosis, negative symptoms, prognostic factors, and to assess the long-term clinical course and level of functioning and adjustment in modern-day schizophrenia.
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