A sample of 301 patients with delusional psychoses was personally followed up an average of 10 years after first admission (by Retterstöl), and 30 years after admission (by the author). Using a multivariate technique the following significant predictors of outcome emerged: discharge diagnosis according to DSM-III (accounted for most of the total variance), marital status, and Axis V at 10-year outcome, and diagnosis, marital status, and gender at 30-year outcome. No significant difference of outcome was found between patients living in urban and rural areas in bivariate or multivariate analyses. Women did slightly better than men at 10-year follow-up, but at 30-year follow-up men did significantly better. These results may be consistent with the hypothesis that other factors than those occurring during the premorbid period are manifest in the later course of the disorder. However, Axes IV and V proved useful, stressing the necessity of working with social as well as psychopathological issues when patients are treated.