ABSTRACT
Recent long-term studies have questioned the idea that schizophrenia becomes progressively worse over the long term (Harding, 1986; Harding, Zubin, & Strauss, 1987). Instead, outcome can vary along a continuum between complete recovery and total incapacity. Three studies, the Vermont Longitudinal Project (Harding, Brooks, Ashikaga, Strauss, & Breier, 1987) the Lausanne Investigations (Ciompi & Müller, 1976), and the Burghölzli Hospital Study (Bleuler, 1978) used hospitalization patterns to document individual course trajectories over many decades. Harding (1988) found both similarities and disparities among these studies in the percentage of subjects with various course types. However, all three groups displayed heterogeneity of course trajectories. The trajectories for Vermont subjects revealed a variety of individual course patterns (Harding, McCor-mick, Strauss, Ashikaga, & Brooks, 1989). The authors concluded that severe psychiatric disorder is not a unitary, linear process, but one that ebbs and flows at different rates across different areas of functioning.
