Which combination of features indicates the POOREST long-term prognosis in schizophrenia?

• A Insidious onset, prominent negative symptoms, male sex, family history of schizophrenia ✓
• B Acute onset, prominent mood symptoms, married, late onset
• C Abrupt onset with precipitating stressor, good premorbid personality, female sex
• D Onset after age 35, paranoid subtype, preserved insight between episodes

Explanation

Poor prognostic indicators in schizophrenia include insidious onset, early age of onset, male sex, prominent negative symptoms, poor premorbid functioning, family history of schizophrenia, substance use, and lack of a precipitating stressor. Acute onset with an obvious precipitant, later onset, female sex, paranoid subtype, and presence of mood symptoms or a supportive marriage are all associated with a better outcome, making option A the clearly adverse profile.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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