The course of schizophrenia is as variable as its symptoms. Systematic investigations of the courses of the psychoses were initiated by Kraepelin who believed that, in the absence of demonstrable brain pathology and aetiology, a common outcome into 'psychic weakness' of the clinical syndromes he grouped together as dementia praecox would provide a validity test for the disease entity. Later, Kraepelin revised his claim that the prognosis of dementia praecox was invariably poor and noted that 'permanent cures' had occurred in about 15 per cent of his cases.(1) Subsequent longitudinal studies have confirmed the striking variability of course as one of the salient characteristic of the 'natural history' of schizophrenia.

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