[Clinical psychopathologic study of aged chronic schizophrenics in residential homes for the elderly--relapsed and non-relapsed].
Residential homes for the elderly are expected to play an important role in the future as places for the social rehabilitation of inpatients with chronic schizophrenia in psychiatric hospitals. A study was performed to investigate the state of adjustment of schizophrenics currently staying in residential homes for the elderly from the viewpoint of clinical psychopathology. The subjects, consisting of 26 schizophrenics (10 males and 16 females) with a mean age of 76.0 years (SD = 5.4), were followed up mean 9.1 years (SD = 5.3). Background factors and clinical features of these subjects were compared in two groups divided according to relapsed (N = 16) or non-relapsed disease (N = 10). The results showed that there was a significant difference in the style of interpersonal relations (passive type and aggressive type). Passive type (N = 19) is autistic and meek. Aggressive type (N = 7) is uncooperative and has persecution mania towards any situation. All relapsed subjects were belonged to passive type. These subjects of the passive type who adjusted better than average during the stable phase experienced relapse more frequently than those of the aggressive type. And when they had a relapse, they revealed the same kind of symptoms as they had once revealed during their younger days, even though they usually seemed to be a better adaptation than the other group. In other words, their apparent stable condition represented unnatural adjustment that could also be described as overadjustment. The study revealed that persistent pathological anxiety underlies their adjustment, while the fundamental structure of schizophrenia, as indicated by the vulnerability of ego, remained unchanged even when they were elderly, and that their disease relapse as a result of any precipitating situation. All but 2 patients, including one who committed suicide and one who left the home due to exacerbated mental symptoms, were found to have adjusted to living in the home while under treatment. So adjustment prognosis of schizophrenia in the home is good.
Department of Psychiatry, Tokyo Jikei University School of Medicine.
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Matsuzawa
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D011599:Psychopathology; D012008:Recurrence; D012565:Schizophrenic Psychology