Del 20 al 30% de los pacientes logran llevar una vida relativamente normal. El otro 20-30% experimenta síntomas moderados. Y el 40-60% restante lleva una vida perturbada por el trastorno.
Factores de buen pronóstico
*Edad tardía de comienzo.
*Comienzo agudo de la enfermedad.
*Existencia de factores precipitantes: drogas.
*Ausencia de embotamiento afectivo.
*Factores precipitantes de la enfermedad claramente identificables.
*Si la persona presentaba buena adaptación social, sexual y laboral antes de la aparición de la enfermedad.
*Ambiente social y familiar favorable.
*Buen cumplimiento del tratamiento.
*Antecedentes familiares de trastornos de humor.
*Confusión y síntomas atípicos.
*El subtipo de mejor pronóstico es la Esquizofrenia Paranoide.
Factores de mal pronóstico:
*Inicio en edad temprana.
*Comienzo progresivo o insidioso de la enfermedad.
*Prevalencia de síntomas negativos.
*Aislamiento social o pocos sistemas de apoyo social.
*Trastorno previo de la personalidad.
*Embotamiento afectivo.
*Historia familiar de esquizofrenia.
*Larga evolución antes del primer contacto médico.
*Abuso de drogas.
*Presencia de anomalías cerebrales claras (ventrículos dilatados).
*Cuando la enfermedad no remite en tres años y hay múltiples recaídas.
*La esquizofrenia de tipo Desorganizado es la de mayor gravedad.
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