Through a critical analysis of the peer-reviewed scholarly literature and reliance on primary and secondary historical sources, the current chapter will critically investigate three key aspects of the schizophrenia syndrome as they relate to outcome: 1. the emergence and metamorphosis of the diagnostic category over time beginning with Kraepelin’s and Bleuler’s seminal definitions at the turn of the twentieth century to DSM-5 formulations; 2. an analysis of large-scale, systematic, group studies of outcome beginning with the Iowa 500 study in the 1970s (Tsuang et al., 1979), through contemporary work, and how these findings have influenced thinking about patterns of recovery and disability in the disorder over recent history; and 3. the emergence and metamorphosis of psychosocial treatments for the disorder beginning in the 1890s through current practices. The chapter will seek to illuminate how changes in the ascendancy of conceptual models of schizophrenia in different historical epochs have influenced diagnostic formulations, treatment approaches, and understanding of outcome in the disorder.

Gian Vittorio Caprara was born in Italy in 1944. He is Emeritus Professor in Psychology at the University of Rome and was also a fellow at the Netherlands Institute for Advanced Study and at the Swedish Collegium for Advanced Study. He founded the Interuniversity Center for the Study of Prosocial and Antisocial Motivation in Italy. He studied three major topics – personality, aggression, political preferences and participation – with an interactionist and social cognitive approach in which personality is considered a self-regulatory system while biological potential is mostly conditioned by culture. He initiated the Genzano Longitudinal Study, which followed 10-year-old children from elementary school through adolescence. The study focused on the development of aggression and prosocial behavior; stability and change in personality; the determinants of academic achievement and vocational choices; family and romantic relations; and civic and political behavior. The study investigated how different aspects of personality operate in concert. The aim was to clarify pathways that lead to maladjusted and risky behaviors. The findings led to the development of a theory that assigns to marginal deviations from normative behaviors a crucial role in the development of maladjusted behavior. The study also led to psychosocial interventions promoting and sustaining healthy development.