title: Treatment of schizophrenia: implications derived from an intercultural hospital comparison between Germany and Japan.
abstract: OBJECTIVE
  The study was aimed at evaluating facets of psychiatric inpatient care of patients with schizophrenia in a German and a Japanese hospital.
  
  
  METHODS
  Based upon a sample of 865 inpatients of the Psychiatric State Hospital Regensburg (BKR) and 50 inpatients of the Tokyo Women's Medical University (TWMU) admitted in 1997, data of a psychiatric basic documentation system (BADO) were analysed with regard to essential process and outcome indicators.
  
  
  RESULTS
  Despite dissimilarities between both patient groups with respect to schizophrenic subtype, duration of illness as well as severity of illness and psychosocial functioning, the differences regarding therapeutic treatment and outcome were marked. In 1997, the rate of atypical neuroleptics was 18% at the BKR and 12% at the TWMU. Inpatients of the TWMU were given benzodiazepines and anticholinergic drugs significantly more frequently. Male patients of the TWMU showed more severe side-effects. Psychotherapy and sociotherapy were less frequently applied at the TWMU. Although the patient groups did not differ with regard to suicidal behaviour and overt aggressions during hospitalisation, we found a higher rate of mechanical restraints at the TWMU. In 1997, the average length of stay was significantly higher at the TWMU (153 days) than at the BKR (52 days), but inpatients of the TWMU improved only slightly better with regard to global psychosocial functioning (GAF) and severity of illness (CGI).
  
  
  CONCLUSIONS
  The revealed differences in treatment are likely due to differences in service provision and national practices in Germany and Japan and provide clues for quality improvements. The BADO is a useful tool for continuous quality management and an ongoing international exchange concerning psychiatric inpatient care.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, Germany. bettina.huebner-liebermann@medbo.de
authors.forename: B
authors.initials: B
authors.lastname: Hübner-Liebermann
authors.forename: H
authors.initials: H
authors.lastname: Spiessl
authors.forename: K
authors.initials: K
authors.lastname: Iwai
authors.forename: C
authors.initials: C
authors.lastname: Cording
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D003431:Cross-Cultural Comparison; D018864:Cultural Diversity; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006783:Hospitals, State / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012149:Restraint, Physical / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data
chemical_list: D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists; D001569:Benzodiazepines