Activation symptoms and discharge in elderly chronic schizophrenic inpatients.
Three hundred thirty-three elderly schizophrenic inpatients were rated on the Positive and Negative Syndrome Scale (PANSS), and those remaining in the hospital after 1 year (N = 267) were rated and followed for an additional year. Based on previous studies showing that aggressive episodes and hostile behavior predicted inability to discharge schizophrenics, we hypothesized that low discharge rates would be correlated with high baseline ratings on the activation factor of the PANSS (PANSS-AF), obtained by summing six items (hostility, poor impulse control, excitement, uncooperativeness, poor rapport, and tension). Baseline PANSS-AF scores were found to be inversely correlated with discharge rates, independent of ratings on other symptom dimensions. PANSS-AF scores were a better predictor of outcome than any individual PANSS item (e.g., hostility), and individual item scores did not add significantly to prediction of discharge. Attention to and development of treatments for activation symptoms, highly prevalent in schizophrenia but not included in our present diagnostic systems, may increase the chances of elderly inpatients with schizophrenia of moving to community settings.
White
Leonard
L
Mount Sinai School of Medicine, New York, New York, USA.
Opler
Lewis A
LA
Harvey
Philip D
PD
Parrella
Michael
M
Friedman
Joseph I
JI
D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D002908:Chronic Disease; D003156:Community Mental Health Services; D005163:Factor Analysis, Statistical; D005500:Follow-Up Studies; D005852:Geriatric Psychiatry; D006760:Hospitalization; D006783:Hospitals, State / Q000706:statistics & numerical data; D006791:Hostility; D006801:Humans; D016014:Linear Models; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011595:Psychomotor Agitation / Q000175:diagnosis; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy; D012565:Schizophrenic Psychology