To What Extent Does Symptomatic Improvement Result in Better Outcome in Psychotic Illness?

A sample of 708 patients with chronic psychotic illness was assessed on three occasions over 2 years. A multilevel analysis was conducted to examine to what degree reduction in psychopathological scores was associated with improvement in service use, disability, subjectives outcomes, & measures of self-harm. The analyses revealed strong associations between behavioural & cognitive measures of self-harm & positive symptoms. One unit increase in positive symptoms over the 2 years was associated with a 50% excess risk for parasuicide & a 50% excess risk for suicidal thoughts. However, change in depressive symptomatology did not impact on parasuicide. Findings suggest that changes in distinct psychopathological dimensions independently & differentially influence outcome. (44 refs.)