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This review is an attempt to clarify the significance of criteria in the establishment of prognosis in schizophrenia. A survey of the available and relevant literature revealed that varying degrees of prognostic value were attributed
to the following criteria which are of the greatest import in the assessment of prognosis in schizophrenia.
The prognosis is most favorable when: (1) the duration of the illness is short, (2) the type of onset is acute, (3) exogenic precipitating factors are obvious, (4) the element of confusion or clouding of consciousness and atypical symptoms (especially manic-depressive symptoms) are prominent in the early symptomatology, (5) process symptoms are minimal. Conversely when these conditions are reversed the prognosis is least favorable.
There are certain other significant factors whose relative importance cannot be clearly evaluated at the present time, i.e., (1) patients with a history of a previous episode of illness have a better chance of remission, the more so the longer the interval between attacks and the more complete the recovery during the preceding remission; (2) the asthenic body-type is unfavorable; (3) the pyknic body-type is favorable; (4) extravert temperament and adequate prepsychotic life adjustment offer a more favorable outlook in contrast to introversion and inadequacy of reaction to life situations; (5) the catatonic type offers the best prognosis and paranoids the worst, with the simple and hebephrenic type in an intermediate position; (6) acute cases which are so atypical as not to allow classification under any of these five types are especially favorable prognostically; (7) a progressive hospital course is ominous, whereas improvement or fluctuation is indicative of a more favorable outcome; (8) sex, education, abilities, psychosexual history seem to have no prognostic significance. Age at onset of illness is also of no prognostic significance except that relatively late age offers an unfavorable prognosis