Progressive Ventricular Expansion in Chronic Poor-outcome Schizophrenia

Objective: To compare progressive changes in lateral ventricular size in chronic schizophrenia patients with good and poor outcomes. Background: Several longitudinal studies associated excessive ventricular enlargement with poor outcome early in the course of schizophrenia. Changes in its chronic phase have not been as well ascertained. Methods: We used MRI to evaluate progression of the lateral ventricular size in 49 chronic schizophrenia patients (26 with poor outcome, 23 with good outcome) and 16 healthy comparison participants, scanned twice 4 years apart. Results: In comparison with healthy participants, schizophrenia patients displayed significantly enlarged body, and anterior and posterior horns of the lateral ventricles at baseline and follow-up, but no between-group differences in their longitudinal expansion were observed. Progressive enlargement of the posterior horn in the poor-outcome (Kraepelinian) group, however, was more pronounced than in schizophrenia patients with good outcome. Conclusions: Excessive ventricular enlargement in the chronic phase of schizophrenia may be specifically associated with poor functional outcome of the illness.