Changes in the clinical picture of schizophrenia

Records of all patients admitted to inpatient facilities of a state department of mental health from 1948 to 1952 and from 1965 to 1969 and diagnosed schizophrenic were reviewed to determine diagnostic trends, if any. The percentage of diagnoses of the catatonic subtype showed a general decline, the hebephrenic subtype showed a marked decline, the paranoid subtype a general increase, and the nonclassical subtypes a marked increase. Analysis of the symptoms for the subtypes and comparison between subtypes did not reveal any particular symptoms to be totally characteristic of a specific subtype. Many symptoms occurred with approximately equal frequency in all subtypes. Comparison of patients' symptoms for the two periods did not reveal wide qualitative variation between periods. However, there were large quantitative variations. We conclude that the apparent change in schizophrenia is but a moderation of primary symptoms.