Social dysfunction and treatment failure in schizophrenia

Recent evaluation of a 20-year-old experimental ward resocialization program for chronic schizophrenics indicates that the general level of activity, much of it social, was disruptive to the psychological functioning of patients, particularly sicker ones. Antipsychotic drugs positively affected psychological functioning and also decreased social behavior. A review of other studies indicates that we are not unique in finding that intensive socioenvironmental therapies have adverse effects on schizophrenics. Furthermore, a wide range of studies indicates that schizophrenics are prone to avoid social interaction and show a decrement in functioning as the intensity of such interactions increases. Unfortunately, although various hypotheses seem feasible, little is known about the reasons for schizophrenics' social dysfunction and little research is presently being done. Given the recent findings that neuroleptic drug treatment by itself is insufficient to keep many patients out of the hospital and that those that stay in the community show an increase in withdrawal, the development of successful treatment programs for schizophrenia may hinge upon our learning more about the nature of and reasons for the schizophrenic's social dysfunction.