A longitudinal study of psychiatric outcome: Developmental variables vs. psychiatric symptoms

Abstract

Using multiple regression techniques, this study investigated the prognostic significance of childhood school behavior, home environment, adult premorbid social competence, and psychiatric symptoms at first admission in 141 psychiatric patients. The analyses focused on known psychiatric outcome, deliberately disregarding diagnoses. The presence of hallucinations at initial hospitalization was the surest indicator of poor prognosis. Withdrawal in men and perplexity or confusion in women were about equally dependable predictors. Length of hospitalization was easily foretold for both sexes by level of social competence attained before breakdown. Childhood developmental variables implicating individual personality traits and family disruption were at least as discriminating as adult psychiatric symptoms in predicting long-term outcome: ten of the significant predictors concerned childhood school behavior or the home environment, as compared with five psychiatric symptoms. Prediction equations based on the multiple regression analyses accurately classified the outcome of more than half of the patients. These results underline the importance of taking a robust longitudinal perspective in prognostic formulations, rather than a narrowly time-limited diagnostic perspective.