[Discharge of elderly schizophrenics after prolonged hospitalization]

Discharge of patients from psychiatric institutions has received great attention in recent decades from both the research and clinical points of view. This study identifies and characterizes long-stay, elderly, schizophrenic patients considered candidates for discharge. Of 62 patients aged 60 years and over, residing in open wards of a large public psychiatric hospital for more than a year, 31 fulfilled DSM-3R criteria for schizophrenia. They constituted a "young-old" population, in prolonged, continuous psychiatric hospitalization, who became ill early in life. Their educational and occupational achievements were relatively limited. A mild degree of psychopathology was found, with more negative than positive symptoms of schizophrenia. Their psychiatric symptoms necessitated constant treatment with neuroleptics at moderate to high dosage. Scores on cognitive tests were lower than those of normal age-matched individuals, and indicated a diffuse, cognitive deficit. They fulfilled current criteria for being independent (no need for help in activities of daily living) or "fail" (some help needed). In most there was impaired social and occupational functioning. Suitability for referral to suggested alternatives to psychiatric hospitalization in the community or in the geriatric system is discussed.