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Institutionalization and the defects of schizophrenia
The British Journal of Psychiatry : the Journal of Mental Science
|September 1, 1981
Summary
Long-term follow-up of schizophrenia patients shows disease-related deficits, not institutionalization, are the primary cause of chronic symptoms. Cognitive impairments were noted in both discharged and in-patients.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Schizophrenia is a chronic mental illness with significant long-term impacts.
- The role of institutionalization versus inherent disease processes in chronic schizophrenia deficits is debated.
Purpose of the Study:
- To compare the long-term functioning of schizophrenia patients after hospital discharge with in-patients.
- To determine the extent to which institutionalization contributes to deficits in chronic schizophrenia.
Main Methods:
- A cohort of 120 schizophrenia patients (Feighner criteria) discharged from hospital were followed for 5-9 years.
- Assessment included mental state, cognitive, behavioral, and neurological functioning, compared with casenote data.
- Findings were compared to an earlier study of 510 schizophrenia in-patients.
Main Results:
- No significant differences in positive/negative schizophrenic features or behavioral performance were found between discharged and in-patient groups when controlling for age and illness duration.
- In-patients exhibited poorer performance on cognitive tests compared to discharged patients.
- Long-term deficits in schizophrenia appear primarily linked to the disease itself.
Conclusions:
- The study suggests that cognitive, behavioral, and neurological deficits in chronic schizophrenia are largely integral to the disease process.
- The impact of institutionalization on these deficits appears relatively small.
- Findings highlight the persistent nature of schizophrenia-related impairments.