Psychosocial outcome in schizophrenia and psychotherapeutic orientation.
The purpose was to compare the psychosocial outcome in two groups of schizophrenic patients who were treated by different methods but were in other respects unselected, and to consider factors predictive of the outcome. The first sample, consisting of a total of 100 patients, had received hospital and outpatient care, here called traditional; only 12 of them had received sustained psychotherapy. Of the second sample, comprising 75 patients, 66 were treated in a psychotherapeutic community and 25 also received sustained psychotherapy. All patients were interviewed by the author on an average of 8 years after the first hospitalization. The patients treated in the psychotherapeutic community had remained longer under hospital care, particularly at first, and at the end of follow-up their functional capacity was lower, but they were more satisfied with the treatment received compared with the patients treated traditionally. The samples did not differ in terms of clinical status. The severity of the schizophrenic disorder, including diagnostic category, and a tendency toward grandiose thinking emerged as the most important factors predictive of psychosocial outcome. Premorbid psychosocial development and social support were also relevant to the outcome. After taking the predictor variables into account, extensive hospital care was still associated with a poor outcome. This may in part explain why, despite the greater amount of psychotherapy provided, the functional capacity of the patients who received psychotherapeutic community treatment had poorer outcome than those treated traditionally.
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D005387:Finland; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D011613:Psychotherapy; D012559:Schizophrenia / Q000628:therapy*