Increased intracerebral cerebrospinal fluid spaces predict unemployment and negative symptoms in psychotic illness. A prospective study

Background. It has been suggested that the dimensions of cerebral ventricles are a risk factor for poor outcome in psychotic illness. Method. A cohort of 140 patients with functional psychoses of recent onset who had undergone CT scanning, were followed up for an average of 45 months and assessed on six dimensions of course and outcome of illness. Results. Left and right sylvian fissure volumes and, to a lesser extent, third ventricular volume predicted negative symptoms and unemployment over the course of follow-up, the latter association being mediated by poor cognitive functioning. There was a significant linear trend in risk over the distribution of sylvian fissure volumes in the cohort, and associations were especially evident in schizophrenic patients. No associations were found with global severity of illness, duration of hospital stay, homelessness, or affective symptoms. Conclusions. These findings support the notion that dimensions of the cerebral ventricles are a continuous risk factor for some measures of outcome in the functional psychoses.