[Current knowledge about the rehabilitation of chronic psychiatric patients]

Our considerations are based upon a new concept of schizophrenia and upon our clinical experience which has been controlled in two catamnestic studies. The new concept contains the notion of vulnerability, saying that there is no specific process underlying mental illness but there is a variety of interacting organic and psychosocial factors causing a special vulnerability leading towards psychotic break down in situations of stress. An optimal treatment should therefore consist of preventing relapse and at the same time of a soft promoting of social learning; thus an optimal treatment is a rehabilitation. Clinical experience and catamnestic studies show that mentally ill patients can be reintegrated into occupation and independent living even after a long history of illness and hospitalization. But we also find a severe ongoing handicap concerning social relations and quality of life, a strong indicator for the fact that rehabilitation has to continue even after a successful reintegration.