Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-24T17:22:24.553Z Has data issue: false hasContentIssue false

A 15-year follow-up of schizophrenia in Ireland

Published online by Cambridge University Press:  13 June 2014

Aine Finnerty
Affiliation:
The Health Research Board, 73 Lower Baggot Street, Dublin 2, Ireland
Fiona Keogh
Affiliation:
The Health Research Board, 73 Lower Baggot Street, Dublin 2, Ireland
Anne O'Grady-Walsh
Affiliation:
Tallaght Hospital, Dublin 24, Ireland
Dermot Walsh
Affiliation:
The Health Research Board, 73 Lower Baggot Street, Dublin 2, Ireland, and St Loman's Hospital, Dublin, Ireland

Abstract

Objectives: Psychiatric hospitalisation rates in Ireland have been high. Recent studies indicate that this is not a consequence of raised incidence. This study explored the possibility that poor outcome may have been responsible for this high hospitalisation prevalence.

Method: Through participation in the WHO Study, Determinants of Outcome of Severe Mental Disorders (DOSMeD), we followed up a cohort of 67 first-onset schizophrenic patients over 15 years to determine symptomatic and functional outcomes and to compare these with outcomes of the cohorts recruited to the International Study of Schizophrenia (ISoS).

Results: Thirty-seven (55%) of the original 67 were successfully followed up over 15 years and, of these, 43% were continuously psychotic for most of the period; a similar proportion had recurrent episodes of illness; two-thirds of subjects had moderate to severe symptoms for most of the time; and, in terms of functional outcome, over four-fifths were unemployed at follow-up.

Conclusions: Outcome for the majority of followed-up patients was poor in symptomatic and functional terms. While this outcome was one of the poorest among the DOSMeD groups the question whether functional psychotic illness outcome is inherently poorer in Ireland than elsewhere remains unanswered. The high rate of attrition (45%) from the group during the follow-up period vitiated interpretation of outcome overall. The high number of suicides among the group was noteworthy.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Commission of Inquiry on Mental Illness. Report of the Commission of Inquiry on Mental Illness. Dublin: Government Publications Office, 1966.Google Scholar
2.NI Nualláin, N, O'Hare, A, Walsh, D. Incidence of schizophrenia in Ireland. Psychological Med 1987; 17: 943–48.CrossRefGoogle Scholar
3.Sartorius, N, Jablensky, A, Kortens, Aet al.Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Med 1986; 16: 909–28.CrossRefGoogle ScholarPubMed
4.Jablensky, A, Sartorius, A, Ernberg, Get al.Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organisation ten-country study. Psychological Medicine 1992; Monograph supplement 20.Google Scholar
5.Sartorius, N, Gulbinat, W, Harrison, G, et al.Long-term follow up of schizophrenia in 16 countries. Social Psychiatry and Psychiatric Epidemiology 1996; 31: 249–58.CrossRefGoogle ScholarPubMed
6.Wiersma, D, Nienhuis, FJ, Giel, R, et al.Assessment of the need for care 15 years after onset of a Dutch cohort of schizophrenic patients and an international comparison. Social Psychiatry and Psychiatric Epidemioiogy 1996; 31: 114–21.CrossRefGoogle Scholar
7.Harrison, G, Hopper, K, Craig, T, et al.Recovery from psychotic illness: a 15- and 25- year international follow-up study. Br J Psychiatry 2001; 178: 506–17.CrossRefGoogle ScholarPubMed
8.Mason, P, Harrison, G, Glazebrook, C, Medley, I, Croudace, T. Characteristics of outcome in schizophrenia at 13 years. Br J Psychiatry 1995; 167: 596603.CrossRefGoogle Scholar
9.Harrison, Get al.The course of schizophrenia over 13 years: A report from the International Study on Schizophrenia (ISoS) co-ordinated by the World Health Organisation. Br J Psychiatry 1996; 169: 580–6.Google Scholar
10.Ganev, K, Onchev, G, Ivanov, P. A 16-year follow-up study of schizophrenia and related disorders in Sofia, Bulgaria. Acta Psychiat Scand 1998; 98: 200–7.CrossRefGoogle ScholarPubMed
11.Wing, JK, Cooper, JE, Sartorius, N. The measurement and classification of psychiatric symptoms. Cambridge and London: Cambridge University Press, 1974.Google Scholar
12.Jablensky, A, Schwarz, R, Tomov, V. WHO collaborative study on impairments and disabilities associated with schizophrenic disorders. Acta Psychiat Scand 1980; 62: (suppl. 285), 152–63.CrossRefGoogle Scholar
13.Endicott, J, Spitzer, R, Fleiss, JL, et al.The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976; 33: 766–71.CrossRefGoogle Scholar
14.Craig, TJ, Siegel, C, Hopper, K, Lin, S, and Sartorius, N. Outcome in schizophrenia and related disorders compared between developing and developed countries. Br J Psychiatry 1997; 170: 229–33.CrossRefGoogle ScholarPubMed