The course of schizophrenia before a patient's first admission is
important theoretically, prognostically, and from a preventive psychiatric
perspective. However, there is little systematically collected information
on this topic. In this evaluation of a representative sample of
first-admission schizophrenic patients, there was a wide variation in
chronicity of psychotic symptoms before admission, with 20% of the patients
having been symptomatic for more than 2 years and 28% for less than 1 week.
Delusions of grandeur, delusions of reference, and suspiciousness were more
common in the more chronic patients than in the most acute patients;
symptoms of withdrawal and retardation showed the opposite pattern. The
authors discuss the implications of these findings for prognosis,
prevention, and theory.