A five-year outcome study of schizophrenia in Jamaica [abstract]

ABSTRACT

OBJECTIVE: The prospective comparison of a sub-cohort of persons diagnosed with schizophrenia five years from initial contact with the mental health care system in Jamaica. METHOD: In a five-year follow-up study, a sub-cohort of 54 patients (M=37, F=17 aged 15-55 years was reassessed from the initial cohort of 317 patients identified in 1992 with a CATEGO ñ diagnosis of schizophrenia. The sub-cohort was chosen from one rural parish (St.Thomas) and one mixed urban/rural parish (St.Catherine). The main outcome measures collected from case notes and patient interviews included clinical status and medication usage at contact with clinical service, employment status, outpatient clinical compliance, relapse rate, and Krawiecka and Goldberg rating scale for the severity of psychotic symptoms. RESULTS: Relapse rate at year five was 14 percent. There were no significant differences between the number of relapses in the first year and the fifth year (z= -2.714, p= 0.007, Wilcox sign test). Outpatient compliance five years from onset showed 97.3 percent of patients had been in contact with the community mental service at least twice during the five-year period. CONCLUSIONS: The favourable outcome in the fifth year after first contact is consistent with the previously reported favourable outcome in the first year after initial contact with the mental health care system in Jamaica. More importantly, the relapse rates continue to be well below the present worldwide relapse rate. (AU)