Psychiatric chronicity and diagnosis

The relationship between psychiatric chronicity and schizophrenia in the postacute phase was examined by comparing posthospitalized chronic schizophrenics and chronic nonschizophrenics on symptoms, social functioning, and recidivism. No differences were found between the groups on any of these variables, indicating a general similarity of clinical picture for chronic schizophrenics and chronic nonschizophrenics in the postacute phase. These results were contrasted with two other comparisons made irrespective of diagnosis: (1) Patients with better social functioning were compared to patients performing less well socially; (2) patients living with others were compared with patients living in isolated settings. In both these comparisons, significant differences in the clinical picture were found between the two groups. Thus, living situation and degree of social functioning both appear to have more relevance for the postacute phase than does diagnosis. These results were related to the genetic and outcome literature on chronic psychiatric disorder to advance the view that the diagnosis of chronicity is more crucial for the understanding of severe emotional disorders than the traditional symptom-based DSM-III classification system.