A longitudinal study of positive symptoms in schizo-affective and paranoid schizophrenia

The purpose of our work was studying the evolution of positive psychopathological symptoms in patients who had suffered from schizo-affective (N=146) and paranoid schizophrenia (N=74) (according to ICD-9CM) for at least 5 years. Using the list of syndromes taken from the Present State Examination, we retrospectively analyzed 2118 relapses registered in these patients' life during their illness (mean 18.1 years). According to our data, when the course of schizo-affective and paranoid schizophrenia incorporates definite periods of remission, there is a tendency towards a simplification of positive symptoms: 1. for 26.4% of the patients, the illness manifested itself in infrequent relapses (once in 4-5 years or less); 2. in 45.9% of the patients (those who displayed prominent regressive tendencies) psychotic symptoms were replaced by symptoms of affective, primarily depressive, type; 3. in 18.6% of the patients the illness took the form of recurring uniform attacks; 4. only in a mere 9.1% of the patients was the disorder diagnosed as progressive; and 5. a tendency to improvement and favorable prognosis was more pronounced in schizo-affective schizophrenia patients than in patients with paranoid schizophrenia (69.9% vs 54.1%, P < 0.05).