Schizophrenia: treatment issues in the 21st century

  • Wolfgang Gaebel
Conference paper


The classification and prediction of illness course and outcome of schizophrenia has been a source of interest to researchers since its first description. ICD10 and DSM-IV offer operationalizations of the major course types. According to Watt et al. (1983), the prevalence of different course types depends on whether first or multiple episode patients are studied. In the prognostically more favorable acute course, the course type one episode no residuum prevails with 23% of cases,multiple episodes with no or minimum residuum amount to 35% of cases, residuum after the first episode with relapses and no return to normality is seen in 8% of cases, and increasing residuum after each episode and no return to normality in 33% of cases. Three stages of a lifelong illness course have been described (Breier et al. 1992): a deterioration stage in the early phase of the illness, a stabilization stage in the middle years, and an improvement stage in the late years. Treatment outcomes improved with the advent of neuroleptic drug treatment between the period of 1910 and 1990. Since the 1950s, the new psychosocial and psychological treatments have led to improvements, which however seem to have deteriorated again since the 1980s due to a shift from Bleulerian to neo-Kraepelinian diagnostic systems (Hegarty et al. 1994).


Treatment Issue Untreated Psychosis Early Schizophrenia German Research Network Quality Management Technique 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • Wolfgang Gaebel
    • 1
  1. 1.Department of Psychiatry, Heinrich-Heine-UniversityRhineland State ClinicsDüsseldorfGermany

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