Which combination of features predicts a GOOD prognosis in schizophrenia?

• A Insidious onset, male sex, prominent negative symptoms
• B Acute onset, presence of precipitating stressor, predominance of positive symptoms ✓
• C Early age of onset, family history of schizophrenia, poor premorbid adjustment
• D Chronic course, unmarried status, flat affect at presentation

Explanation

Classical prognostic teaching holds that acute onset, an identifiable precipitating factor, late onset, married status, female sex, good premorbid functioning, predominant positive symptoms, and a family history of mood rather than schizophrenia all favour recovery. Insidious onset with negative symptoms and early male onset carry a poor prognosis, which makes options A, C, and D collections of adverse factors rather than favourable ones.

Reference: Shorter Oxford Textbook of Psychiatry, 7th ed.

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