Abstract
Background: It is disputed whether the course of schizophrenia
is characterized by a progressive deterioration, or a progressive
amelioration. Furthermore, it has been recently suggested that progression for the collective is actually attributable to a homogeneous group of patients who are frail and so have the propensity to deteriorate. The current study explores the different possible course patterns of schizophrenia in a national population based cohort.
Methods: All first admissions for schizophrenia in Israel from
1978 to 1992 and their subsequent readmissions were followed in
the National Psychiatric Case Registry (n=11,739), which is a
national population listing of all psychiatric hospitalizations in
Israel. Two recurrent Cox proportional hazards models were conducted with and without a frailty parameter that accounts for
heterogeneity, followed by an examination of readmission patterns.
Results: The frailty model performed better than the Cox model
as the addition of the frailty parameter incremented variance
explained by 12% and the heterogeneity estimate was substantial
(variance of random effect=0.794; c2
=41971.15, df=9003, pb.001). Examination of patients with at least ten years of follow up (n=3798), revealed that approximately three-quarters of the patients were admitted to hospital less over time. Most of the remaining patients showed an increasing readmission rate and a few patients were consistently hospitalized.
Conclusions: A majority of patients systematically follow a
course of progressive amelioration, a substantial number deteriorateover time and a minority is consistently hospitalized.
is characterized by a progressive deterioration, or a progressive
amelioration. Furthermore, it has been recently suggested that progression for the collective is actually attributable to a homogeneous group of patients who are frail and so have the propensity to deteriorate. The current study explores the different possible course patterns of schizophrenia in a national population based cohort.
Methods: All first admissions for schizophrenia in Israel from
1978 to 1992 and their subsequent readmissions were followed in
the National Psychiatric Case Registry (n=11,739), which is a
national population listing of all psychiatric hospitalizations in
Israel. Two recurrent Cox proportional hazards models were conducted with and without a frailty parameter that accounts for
heterogeneity, followed by an examination of readmission patterns.
Results: The frailty model performed better than the Cox model
as the addition of the frailty parameter incremented variance
explained by 12% and the heterogeneity estimate was substantial
(variance of random effect=0.794; c2
=41971.15, df=9003, pb.001). Examination of patients with at least ten years of follow up (n=3798), revealed that approximately three-quarters of the patients were admitted to hospital less over time. Most of the remaining patients showed an increasing readmission rate and a few patients were consistently hospitalized.
Conclusions: A majority of patients systematically follow a
course of progressive amelioration, a substantial number deteriorateover time and a minority is consistently hospitalized.
| Original language | English |
|---|---|
| Pages | 251-252 |
| Number of pages | 2 |
| DOIs | |
| State | Published - 2006 |
| Event | The 13th Biennial Winter Workshop on Schizophrenia Research - Davos, Switzerland Duration: 1 Jan 2006 → 1 Jan 2006 |
Conference
| Conference | The 13th Biennial Winter Workshop on Schizophrenia Research |
|---|---|
| Country/Territory | Switzerland |
| City | Davos |
| Period | 1/01/06 → 1/01/06 |