Twelve-year clinical course of schizophrenia from 1971/73 to 1983. A longitudinal study of clinical course and a cross-sectional study 12 years after hospital or night-clinic treatment.
Two samples of 46 schizophrenic patients, one of new attendees at a night clinic in 1971-73 and the other of hospitalized patients matched for age and sex, were followed up 12 years later. Seven of the former and two of the latter had died, all from self-destructive acts. Of the survivors, one-third were rated inconspicuous with regard to psychopathology, one-fifth as conspicuous only to a psychiatrist, and only one-quarter as very conspicuous, even to a layperson. During the first 4 years the night clinic patients showed signs of an insidious chronic course; substantially fewer (17.6% compared with 28.6%) were hospitalized at the time of follow-up, though far more were receiving outpatient or semi-inpatient care. In both samples self-isolation and inadequate rehabilitation for work were marked; 72% and 62% respectively were dependent on a disability pension, and only 15% and 20% were employed at work in keeping with their training and experience. Just under half lived alone, and 30-40% had no contact with friends/acquaintances. Longitudinal analysis disclosed a marked decrease in the number and duration of overt phases and stays in hospital, progressive aggravation or residual symptoms in quiescent intervals, and similar decline in ability to work and earn a living. Covariance analysis revealed a significantly greater reduction in total hospitalization in night clinic patients.
Gmür
M
M
Social-psychiatric service, University Psychiatric Hospital, Zurich, Switzerland.
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009551:Night Care; D011569:Psychiatric Status Rating Scales; D012050:Rehabilitation, Vocational / Q000523:psychology; D012559:Schizophrenia / Q000401:mortality / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D015996:Survival Rate