A 15- and 25-year international follow-up study of recovery from psychotic illness found that about 75% of treated incident cases were traced, with about 50% of surviving cases having favorable outcomes, though there was marked heterogeneity across geographic centers. Early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location, with 16% of early unremitting cases achieving late-phase recovery. The study highlights the role of sociocultural conditions in modifying long-term course and suggests that early intervention programs focusing on social as well as pharmacological treatments may realize longer-term gains. The study involved 1633 subjects from 14 treated incidence and four prevalence cohorts. Mortality rates varied by location, with most centers having SMRs significantly greater than one. The study found that recovery was more common in industrialized countries, though there was significant variation across centers. The study also found that early course of illness strongly predicted long-term outcome, but local environment played a significant role in determining symptoms and social disability. The study's findings suggest that schizophrenia and related psychoses are best seen as episodic disorders with a favorable outcome for a significant proportion of patients. The study underscores the importance of sociocultural factors in the longer-term course and outcome of psychosis, and highlights the need for further research to understand the complex interactions between genetic and environmental factors in schizophrenia. The study also found that the concept of recovery requires careful operationalization, and that the results should be interpreted with caution due to potential biases in case ascertainment and assessment methods. The study's findings suggest that clinical and public health efforts to reduce the causes of unnatural death could reduce mortality risk, especially among young males in industrialized countries. The study also found that the timing of onset and emergence of early symptoms may influence the duration of untreated psychosis, but data on this were not consistently reported. Overall, the study provides important insights into the long-term course and outcome of schizophrenia, highlighting the need for continued research and the importance of early intervention programs.A 15- and 25-year international follow-up study of recovery from psychotic illness found that about 75% of treated incident cases were traced, with about 50% of surviving cases having favorable outcomes, though there was marked heterogeneity across geographic centers. Early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location, with 16% of early unremitting cases achieving late-phase recovery. The study highlights the role of sociocultural conditions in modifying long-term course and suggests that early intervention programs focusing on social as well as pharmacological treatments may realize longer-term gains. The study involved 1633 subjects from 14 treated incidence and four prevalence cohorts. Mortality rates varied by location, with most centers having SMRs significantly greater than one. The study found that recovery was more common in industrialized countries, though there was significant variation across centers. The study also found that early course of illness strongly predicted long-term outcome, but local environment played a significant role in determining symptoms and social disability. The study's findings suggest that schizophrenia and related psychoses are best seen as episodic disorders with a favorable outcome for a significant proportion of patients. The study underscores the importance of sociocultural factors in the longer-term course and outcome of psychosis, and highlights the need for further research to understand the complex interactions between genetic and environmental factors in schizophrenia. The study also found that the concept of recovery requires careful operationalization, and that the results should be interpreted with caution due to potential biases in case ascertainment and assessment methods. The study's findings suggest that clinical and public health efforts to reduce the causes of unnatural death could reduce mortality risk, especially among young males in industrialized countries. The study also found that the timing of onset and emergence of early symptoms may influence the duration of untreated psychosis, but data on this were not consistently reported. Overall, the study provides important insights into the long-term course and outcome of schizophrenia, highlighting the need for continued research and the importance of early intervention programs.