Which combination of features at illness onset predicts the POOREST long-term outcome in schizophrenia?

• A Acute onset with prominent affective symptoms and married status
• B Insidious onset, poor premorbid functioning, and prominent negative symptoms ✓
• C Late onset after age 40 with paranoid phenotype
• D Female sex with family history of mood disorder

Explanation

Classical prognostic studies consistently identify insidious onset, poor premorbid social and occupational adjustment, early age of onset, male sex, negative symptoms, and family history of schizophrenia as markers of poor outcome. In contrast, acute onset, prominent affective features, later onset, paranoid subtype, female sex, being married, and a precipitating stressor all predict a more favourable course. This contrast between good and bad prognostic clusters is a frequently examined table fact.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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