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Centre for Evidence-
Based Medicine

Psychosis: 15% Likelihood of remaining relapse free at 15 years

Clinical Bottom Line

Patients with first episode non-affective functional psychosis have a 15% likelihood of remaining free from relapse over 15 years


Wiersma, D, Nienhuis, FJ, Slooff, C.J. and Giel R. Natural course of schizophrenic disorders: a 15-year followup of a Dutch incidence cohort. Schizophr.Bull. 24 (1):75-85, 1998.

Clinical Question

In a patient with first episode functional psychosis, what is the likelihood of remaining free from relapse in the long term?

Search Terms

hand search Evidence-Based Mental Health

The Study

Long term follow up of first-contact cases of non-affective functional psychosis from a geographically defined region in the Netherlands. At 6 months, 63% had DSM-IIIR schizophrenia or schizophreniform disorder. Explicit criteria were used for determining relapse. Data collection was standardised although much was retrospective from casenotes and informants.

The Evidence

Outcome Time Measure Confidence Interval
Relapse-free following remission of first episode 1 year 57% Not calculable
2 years 45% Not calculable
5 years 70% Not calculable
15 years 15% 7 to 22%


Commentary in Evidence-Based Mental Health includes extra information that was obtained from authors

Appraised By

Geddes, 1998

Expiry Date