Long-Term Follow-up of Patients with a Diagnosis of Paranoid State and Hospitalized, 1913 to 1940

• Published in: The journal of nervous and mental disease Vol. 188; no. 4; pp. 202 - 208
• Main Authors: STEPHENS, JOSEPH H, RICHARD, PASCAL, McHUGH, PAUL R
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-04-2000; Lippincott Williams & Wilkins
• Subjects: Adult; Biological and medical sciences; Electroconvulsive Therapy; Female; Follow-Up Studies; Hallucinations - diagnosis; Hospital Records; Hospitalization; Hospitals, Psychiatric; Humans; Institution therapy. Inpatient treatment; Insulin Coma; Male; Medical sciences; Middle Aged; Outcome Assessment (Health Care); Paranoid Disorders - diagnosis; Pentylenetetrazole - therapeutic use; Prognosis; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; Schizophrenia - diagnosis; Schizophrenia, Paranoid - diagnosis; Schizophrenic Psychology; Suicide - statistics & numerical data; Treatments; United States; North America; Maryland; America; Social environment; Human; Hospital discharge; Prognosis; Evaluation scale; Hospital admission; Paranoiac psychosis; Psychometrics; Personality; Long term; Retrospective; Marital status; Treatment; Age of onset; Follow up study; Evolution; Clinical investigation; Premorbid personality; Diagnosis; Delusion psychosis; Comparative study
• ISSN: 0022-3018; 1539-736X
• DOI: 10.1097/00005053-200004000-00002

From a sample of 239 patients diagnosed paranoid state and hospitalized between 1913 and 1940 at the Phipps Clinic, we particularly studied a group of 60 patients without previous hospitalizations, consisting of 57 patients with follow-ups of 5 or more years, and 3 patients who killed themselves (the ultimate follow-up) less than 1 year after discharge. These 60 patients had been retrospectively diagnosed with delusional disorders by DSM-IV criteria. On follow-up, 27% were rated recovered, whereas 52% were rated unimproved. Long-term follow-up was correlated with discharge status. Poor follow-up was significantly correlated with seclusive personality, poor premorbid history, onset 6 months or more before admission, gradual onset, lack of insight, single marital status, and lack of precipitating events. A prognostic scale constructed from the first four of these variables was predictive of long-term outcome. More recent, better treatment results have been contrasted with these findings from an earlier non-drug-treatment era.