Social functioning of patients with schizophrenia in high-income welfare societies.
OBJECTIVE
The study assessed the level of reintegration into the community of patients with schizophrenia in Oslo, Norway, a country with a well-developed social welfare system and low unemployment rates.


METHODS
Eighty-one patients with a DSM-III-R diagnosis of schizophrenia treated in 1980 and in 1983 in a short-term ward of a psychiatric hospital were followed up after seven years. Seventy-four of 76 patients alive at follow-up agreed to participate. Social functioning was measured by the Strauss-Carpenter Level of Functioning Scale and the Social Adjustment Scale.


RESULTS
At follow-up 78 percent of patients lived independently, 47 percent were socially isolated, and 94 percent were unemployed. Thirty-four percent had lost employment in the follow-up period. A poor outcome in terms of social functioning and community reintegration was associated with loss of employment. A good outcome was predicted by short periods of inpatient hospitalization, high levels of education, being married, male gender, and not having a late onset of psychosis.


CONCLUSIONS
The level of homelessness among these patients with schizophrenia was encouragingly low, which may have been expected in a high-income welfare society. However, insufficient efforts were aimed at social and instrumental rehabilitation, and the level of unemployment was alarmingly high.
Melle
I
I
Department of Research and Education of the Division of Psychiatry, Ullevål University Hospital, Oslo, Norway.
Friis
S
S
Hauff
E
E
Vaglum
P
P
D000203:Activities of Daily Living; D000328:Adult; D002908:Chronic Disease; D019049:Developed Countries / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009664:Norway; D017063:Outcome Assessment, Health Care; D012494:Sampling Studies; D012559:Schizophrenia / Q000534:rehabilitation*; D012917:Social Adjustment; D012934:Social Isolation; D012946:Social Welfare; D014478:Unemployment