Long-term course in schizophrenia: concepts, methods and research strategies

Objective: This paper summarizes current knowledge about course and outcome in schizophrenia by selecting particular information and by drawing conclusions in the light of theoretical and methodological considerations, in order to illustrate future research strategies, as well as to consider novel targets of treatment. Method: Based on examples from the literature the concepts of course and outcome as well as intervening factors of course and outcome are discussed by considering study results within their methodological and theoretical framework restrictions. Results: The heterogeneity of the disorder, manifest in its variable phenomenology, illness course, treatment response and outcome, complicates research but at the same time offers clues to elucidate the heterogeneity of aetiology and pathogenesis. The search for intervening factors and predictors is of particular interest in order to explore the illness mechanisms. Conclusion: Future research should focus on the biopsychosocial determinants of course and outcome in methodologically improved longterm studies.