The goal of the overall research project is to further our knowledge about schizophrenia and other major psychoses by a prospective longitudinal investigation involving a 15 year followup of a large sample of patients previously studied prospectively at the acute phase and already followed up four times over a ten year period. The following hypotheses about functioning and adjustment over time in schizophrenia, and about the course of positive and negative symptoms, will be addressed. Hypothesis 1: 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. Hypothesis 2: Psychosis persists or recurs over time in schizophrenia, and in schizoaffective disorders, but remits in other psychotic disorders. Hypothesis 3: Negative-deficit symptoms persist in schizophrenia, and they identify a subgroup of poor outcome schizophrenics. The research involves a multi-faceted prospective, longitudinal investigation of the course of positive symptoms, negative symptoms, and major components of psychosocial functioning and adjustment over time, using a battery of structured interviews, performance tests, thought disorder measures, and behavioral ratings. A large sample of young, non-chronic schizophrenic and schizoaffective disorders, bipolar affective disorders, unipolar psychotic depressives, and non-psychotic disorders 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 delusions, hallucinations, disordered thinking, 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 psychoses, thought disorder, 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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