Prospective comparison of course of disability in antipsychotic-treated and untreated schizophrenia patients.

Acta Psychiatr Scand. 2008 Nov 24; [Epub ahead of print]

Thirthalli J, Venkatesh BK, Kishorekumar KV, Arunachala U, Venkatasubramanian G, Subbakrishna DK, Gangadhar BN.

Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India.

Prospective comparison of course of disability in antipsychotic-treated and untreated schizophrenia patients.

Objective: To compare the course of disability in schizophrenia patients receiving antipsychotics and those remaining untreated in a rural community. Method: Of 215 schizophrenia patients identified in a rural south Indian community, 58% were not receiving antipsychotics. Trained raters assessed the disability in 190 of these at baseline and after 1 year. The course of disability in those who remained untreated was compared with that in those who received antipsychotics.

Results: Mean disability scores remained virtually unchanged in those who remained untreated, but showed a significant decline (indicating decrement in disability) in those who continued to receive antipsychotics and in those in whom antipsychotic treatment was initiated (P < 0.001; group x occasion effect). The proportion of patients classified as 'disabled' declined significantly in the treated group (P < 0.01), but remained the same in the untreated group.

Conclusion: Disability in untreated schizophrenia patients remains unchanged over time. Treatment with antipsychotics in the community results in a considerable reduction in disability.