The objectives of this project are to study: 1) the nature and prediction of long term course and outcome in borderline states (both borderline personality disorder and borderline schizophrenia); 2) the nature and prediction of outcomes in schizophrenia with a special focus on the phenomenon of late onset improvement and/or remission in established chronic schizophrenia. Other objectives involve the study of predictor validity across diagnostic categories, relationships among different dimensions of outcome (especially over time) and assessment methodology in follow-up studies. The project includes 550 patients discharged between 1950 and 1975 from Chestnut Lodge, a small, private psychiatric hospital that specializes in the long term treatment of the severely mentally ill. Ninety percent of the patients carry a diagnosis of schizophrenia or borderline state and most come to admission as treatment failures despite their youth. Investigation will encompass: 1) follow-up of former patients to assess their function currently and during the interim since discharge, 2) independent retrospective assessment of key demographic, diagnostic, premorbid, developmental and familial characteristics from their extensive clinical records, and 3) analysis of the relationships between these sets of data. The study utilizes updated methods of outcome assessment and explores the use of psychodynamic factors as predictor and outcome variables. At follow-up, the majority of patients are in the mid to later decades of life. As such, the sample will provide a first look at the life long consequences of borderline psychopathology and a detailed study of the little known investigated phenomenon of improvement in "hopeless" schizophrenic patients.