A retrospective study of 61 acute schizophrenic patients examined whether any demographic, clinical, and outcome characteristics distinguished patients who improved with placebo or low dosages of
antipsychotics (
PLD patients) from patients who required high conventional dosages of
antipsychotics (HCD patients). Patients in the
PLD group (
n = 30) and HCD group (n = 31) were similar in overall level of psychopathology at admission. Prominent excitement and certain somatic and
auditory hallucinations were significantly more frequent in the HCD patients.
PLD patients were more likely to be female, were hospitalized more rapidly after the onset of
psychosis, and were more often first admissions. Although paranoid symptoms and premorbid
schizoid personality did not differentiate the two groups, nonschizoid patients who were nonparanoid tended to be in the
PLD group while nonschizoid patients who were paranoid tended to be in the HCD group.
PLD patients were less psychotic at discharge, remained out of the hospital for longer periods, and had fewer
rehospitalizations. These results confirm other reports of better outcome for patients successfully treated without medication.
PLD patients were also functioning better as family members 1 year after discharge. Further research is indicated to improve the prediction of which acute psychotic patients will respond without medication or to low dose
neuroleptic treatment and to determine if these predictions are generalizable to other treatment settings.