Recent course and outcome studies

Results of longitudinal studies published in the last decade ( Table... .1) do not add substantially new evidence and tend to corroborate the pattern of outcomes outlined by the earlier studies.

The reported rates of recovery or complete remission vary between 12 per cent(30) and 32 per cent/27ยป If the rates of improvement or partial remission are added to those of complete remission, the general improvement rate over 5 to 15 years of follow-up would be no less than 30 per cent and may be as high as 50 per cent. On the other hand, the proportion of patients with an early deteriorating course of illness without clinical remissions is remarkably similar across different studies and is in the order of 20 to 35 per cent. There is a relationship between the length of the follow-up and the proportions of patients who are reported as recovered, remitting, or deteriorating, with a general trend towards higher improvement rates in long-term studies. For example, the proportion of good outcomes increased from 10 per cent at the 2.5-year follow-up to 17 per cent at 5 years in one of the studies; (19> it was 31 per cent in a study with a follow-up of 21 to 25 years (1Z> and nearly 60 per cent at the end of the 32-year follow-up of the Vermont study. (!,6)

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