Abstract
An unexpected finding of the International Pilot Study of Schizophrenia, launched by the World Health Organization (WHO) in 1967, was that patients in countries outside Europe and the United States have a more favourable short- and medium-term course of the disease than those seen in developed countries. Since then, WHO has intensified its schizophrenia research programme and has initiated a set of international studies that have confirmed these initial findings and explored possible reasons for such differences in the course and outcome of schizophrenia. While such work has provided important findings and has generated additional pertinent hypotheses, it did not explain the differences in outcome. The present paper describes a new initiative in which approximately 2500 subjects involved in previous WHO multicentre schizophrenia studies are being followed up for between 15 and 25 years after initial examination. Nineteen research centres in 16 countries are taking part in this work. The research methodology is described.
Similar content being viewed by others
References
Andreasen NC (1989) The scale for the assessment of negative symtoms (SANS): conceptual and theoretical foundations. Br J Psychiatry 155 [suppl 7] 49–52
Day R (1981) Life events and schizophrenia: the “triggering” hypothesis. Acta Psychiatr Scand 64: 97–122
Day R, Nielsen JA, Korten A, Ernberg G, Dube KC, Gebhart J, Jablensky A, leon CA, Marsella AJ, Olatawura M, Sartorius N, Strömgren E, Takahashi R, Wig NN, Wynne LC (1987) Stressful life events preceding the acute onset of schizophrenia: a crossnational study from the World Health Organization. Cult Med Psychiatry 11: 123–205
Dube KC, Kumar N, Dube S (1984) Long-term course and outcome of the Agra cases in the International Pilot Study of Schizophrenia. Acta Psychiatr Scand 70: 170–179
Jablensky A, Schwarz R, Tomov T (1980) WHO collaborative study on impairments and disabilities associated with schizophrenia disorders. A preliminary communication: objectives and methods. In: Epidemiological research as basis for the organization of extramural psychiatry. Proceedings of the Second European Symposium on Social Psychiatry. Acta Psychiatr Scand 62 [Suppl 285]
Jablensky A, Sartorius N, Ernberg G, anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures: a World Health Organization ten-country study. Psychol Med [Monogr Suppl 20]
Katz MM, Marsella AJ, Dube KC, Olatawura M, Takahashi R, Nakane Y, Wynne LC, Gift T, Brennan J, Sartorius N, Jablensky A (1988) On the expression of psychosis in different cultures: schizophrenia in an Indian and in a Nigerian community. Cult. Med Psychiatry 12: 331–355
Leff JP, Wig NN, Ghosh A, Bedi HJ, Menon DK, Kuipers L, Korten A, Ernberg G, Day R, Sartorius N, Jablensky A (1987) Expressed emotion and schizophrenia in North India. III. Influence of relatives' expressed emotion on the course of schizophrenia in Chandigarh. Br J Psychiatry 151: 166–173
Leon C (1989) Clinical course and outcome of schizophrenia in Cali, Colombia — A 10-year follow-up study. J Nerv Ment Dis 177, 593–606
Sartorius N (1986) Course and outcome of schizophrenia: a preliminary communication. In: Cooper B, Helgason T (eds) Epidemiology and the prevention of mental disorders. pp 195–203
Sartorius N, Kuyken W (1994) Translation of health Status Instruments. In: Orley J, Kuyken W (eds) Quality of Life Assessment: International Perspectives. Springer-Verlag, Berlin Heidelberg 1994
Sartorius N, Shapiro R, Kimura M, Barrett K (1972) WHO International Pilot Study of Schizophrenia. Preliminary communication. Psychol Med 2: 422–425
Sartorius N, Jablensky A, Ernberg G, Leff J, Korten A, Gulbinat WH (1987) Course of schizophrenia in different countries: some results of a WHO international comparative 5-year follow-up study. In: Hafner H, Gattaz WF, Janzarik W (eds) Search for the causes of schizophrenia. Springer, Berlin Heidelberg New York, pp 107–113
Skoda C, Kabesova L, Tomasek L (1982) Five-year follow-up of Prague sample of mentally ill patients. Report from the WHO International Pilot Study of Schizophrenia. I. Design. Methods. Cs Psychiat 78: 344–352
Skoda C, Kabesova L, Tomasek L (1984) Five-year follow-up of Prague sample of mentally ill patients. Results. Report from the WHO International Pilot Study of Schizophrenia. II. Results. Cs Psychiat 80: 155–164
Von Zerssen D, Leon CA, Moller HJ, Wittchen HU, Pfister H, Sartorius N (1990) Care strategies for schizophrenic patients in a transcultural comparison. Compr Psychiatry 31: 398–408
Wig NN, Menon DK, Bedi HJ, Ghosh A, Kuipers L, Leff JP, Korten A, Day R, Sartorius N, Ernberg G, Jablensky A (1987a) Expressed emotion and schizophrenia in North India. I. Crosscultural transfer of ratings of relatives' expressed emotion. Br J Psychiatry 151: 156–160
Wig NN, Menon DK, Bedi HJ, Leff JP, Kuipers L, Ghosh A, Day R, Korten A, Ernberg G, Sartorius N, Jablensky A (1987 b) Expressed emotion and schizophrenia in North India. II. Distribution of expressed emotion components among relatives of schizophrenic patients in Aarbus and Chandigarh. Br J Psychiatry 151: 160–165
Wing JK, Cooper JE, Sartorius N (1974) Measurement and classification of psychiatric symptoms: an instruction manual for the P.S.E. (Present State Examination) and CATEGO program. Cambridge University Press, London
Wing JK, Babor TF, Brugha T, Burke JDJ, Cooper JE, Giel R, Jablensky A, Regier DA, Sartorius N (1990) SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 47: 589–593
World Health Organization (1974) International Pilot Study of Schizophrenia, vol 1. WHO Offset Publication No. 2 ISBN 92 4 170002 5
world Health Organization (1975) Schizophrenia. A multi-national study. Summary of the initial evaluation phase of the International Pilot Study of Schizophrenia. PHP No. 63 (1975) (E,F,S) ISBN 92 4 130063 9
World Health Organization (1979) Schizophrenia: an international follow-up. Wiley and Sons, Chichester
World Health Organization (1988) Psychiatric Disability Assessment Schedule. World Health Organization, Geneva
Author information
Authors and Affiliations
Additional information
On behalf of the collaborating investigators
This paper is based on the data and experience obtained during the participation of the authors in the International Study on Schizophrenia (ISoS), a project sponsored by the World Health Organization, and funded by the World Health Organization, the Laureate Foundation (Untied States of America) and the participating centres.
The chief collaborating investigators in the 19 field research centres and one methodological support centre of this study are: Aarhus: A. Bertelsen; Agra: K.C. Dube; Beijing: Shen Yucun; Cali: C. Leon; Chandigarh: V. Varma; Dublin: D. Walsh; Groningen: R. Giel; Hong Kong: P. Lee; Honolulu: A.J. Marsella; Ibadan: M. Olatawura; Khartoum: T. Baasher; Madras: R. Thara; Mannheim: H. Häfner; Moscow: S.J. Tsirkin; Nagasaki: Y. Nakane; Nottingham: G. Harrison; Orangeburg: E. Laska; Prague: S. Skoda; Rochester: L. Wynne; Sofia: K. Ganev. At WHO Headquarters, Geneva, the study has been coordinated by N. Sartorius (until August 1993), by W. Gulbinat (September 1993–April 1996) and Dr. Janca (since May 1996).
Rights and permissions
About this article
Cite this article
Sartorius, N., Gulbinat, W., Harrison, G. et al. Long-term follow-up of schizophrenia in 16 countries. Soc Psychiatry Psychiatr Epidemiol 31, 249–258 (1996). https://doi.org/10.1007/BF00787917
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00787917