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 × 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.