Prediction of course and therapeutic response in psychiatric diseases.

Abstract

1. The targets: a) it is necessary to specify the areas and types of target variables because at least some of them seem to respond independently of each other and their relevance for the patient may vary considerably. Thus, e.g., psychopathological variables are more applicable to depressed patients, whereas interactional or social variables, or side-effects of therapy may be more relevant for some schizophrenic patients. b) Instruments and procedures of measurement should be adequate for relevant variables, e.g. self-rating or observers' rating; they further should be routinely applicable, e.g. visual analogue scales; and fmally they should give unequivocal data for reliable and valid defmitions of change or response. c) Criteria of change or responses, the latter understood as the effect of a defined intervention (Fig. 1), should be determined quantitatively and operationally, e.g. as a prefixed cut-off point of scalesscores, or as astated extent of the difference between Prognosis of the course and outcome of a disease poses one of the oldest problems in medicine. In ancient times it was the main component of medical art. But also nowadays it should be an important part of the physician's task because the indication of a treatment will or at least should be based on a prognosis of the treated course and outcome of the disease that is better than the untreated or "spontaneous" course and outcome would be. This is related to the fact that the efficacy of a therapy will be judged by comparison of the treated versus the spontaneous course and outcome.