The inability to determine which schizophrenic patients do not require
maintenance medication is a significant gap in current knowledge. This
report describes 23 largely chronic DSM-III schizophrenic patients who,
after a period of inpatient treatment, sustained good outcome without
maintenance antipsychotic medication over an average of 15 years.
Retrospective study of these patients revealed that their distinguishing
characteristics at admission included better premorbid social and
occupational adjustment, higher levels of accrued psychosocial competence
and acquired skills, fewer hebephrenic traits, and the preservation of
affect (depressed mood). Hence, even within a largely chronic patient
sample, classic predictors of good outcome may also be useful in predicting
sustained remission without medication.