Schizophrenia - Course, Natural History and Prognosis

Schizophrenia is a progressive and recurring disease characterized by multiple psychotic relapses. This slide deck covers the course, natural history and prognosis of schizophrenia. Other slides discuss the key components of non-adherence in patients with schizophrenia, highlighting the value of a support system.

This slide deck has been developed in collaboration with the former Lundbeck International Neuroscience Foundation.

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Course, Natural History and Prognosis

This slide covers course, natural history and prognosis of Schizophrenia. Schizophrenia is a progressive and recurring disease characterized by multiple psychotic relapses.

This slide deck is schedules for update summer 2022.

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Course of Schizophrenia

Schizophrenia – Course Natural History and Prognosis – slide 2

Course of Schizophrenia

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Schizophrenia – Course Natural History and Prognosis – slide 3

Schizophrenia is a heterogeneous disease with many dimensions

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Schizophrenia – Course Natural History and Prognosis – slide 4

Schizophrenia: A broad range of symptoms

Source (slide): APA 2013, Pages 99–102; APA 2000, Page 299; Wilk et al. Neuropsychology 2005; 19 (6): 778–786, Page 778; NICE clinical guideline 178, Page 4.

Source (notes): APA 2013, Pages 99–102; APA 2000, Page 299–302; Wilk et al. Neuropsychology…

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Schizophrenia – Course Natural History and Prognosis – slide 5

Schizophrenia progression may lead to functional decline

Key message: Schizophrenia is a progressive and recurring disease characterized by multiple psychotic relapses. Following a relapse, patients often fail to recover to baseline health and this may lead to functional decline.

Background:

The majority of patients with schizophrenia…

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Schizophrenia – Course Natural History and Prognosis – slide 6

Typical Course of Schizophrenia

Review as stated on slide.

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Schizophrenia – Course Natural History and Prognosis – slide 7

Please note, this slide builds

Key message: Many patients experience symptoms that are not fully controlled with treatment, with social withdrawal and impoverished thought being the two most common negative symptoms, and disordered thought and bizarre behavior the two most…

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Schizophrenia – Course Natural History and Prognosis – slide 8

Symptoms that are not fully controlled are significantly associated with impaired global functioning

Key message: In a study of patients in remission, those with residual symptoms had significantly worse global functioning that those without residual symptoms.

Background:

Patients (aged 18–65) in remission with and without residual symptoms were compared regarding psychopathology, functioning…

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Schizophrenia – Course Natural History and Prognosis – slide 9

Disorganization, a common residual symptom,1 is associated with impaired community functioning

Key message: Conceptual disorganization is a common residual symptom in patients with schizophrenia, and is a reliable predictor of several aspects of community functioning, as measured by the Life Skills Profile (which was specifically designed to assess constructs of relevance…

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Schizophrenia – Course Natural History and Prognosis – slide 10

Positive symptoms of schizophrenia are inversely correlated with ability to function

Key message: Increase in positive symptoms is directly correlated with a reduction in functional capacity. The correlation between positive symptoms and depression is predictive of impairment in real-world performance measures (as measured by interpersonal skills, community activities, work skills)

Background

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Schizophrenia – Course Natural History and Prognosis – slide 11

Primary negative symptoms of schizophrenia can impact domains of functioning directly1

Key message: Negative symptoms and cognitive deficits can cause patients functional impairment. Primary negative symptoms of schizophrenia can impact different domains of functioning directly, including interpersonal relations, use of common objects and activities, and instrumental role functioning.

Background