Institutionalization and the Defects of Schizophrenia

1981 ◽  
Vol 139 (3) ◽  
pp. 195-203 ◽  
Author(s):  
Eve C. Johnstone ◽  
D. G. Cunningham Owens ◽  
Aviva Gold ◽  
T. J. Crow ◽  
J. Fiona Macmillan
Keyword(s):  
Mental State ◽  
Disease Process ◽  
Chronic Schizophrenia ◽  
Cognitive Tests ◽  
Duration Of Illness ◽  
Cognitive Behavioural ◽  
Discharged Patients ◽  
Neurological Functioning ◽  
Behavioural Performance ◽  
Integral Feature

SummaryPatients conforming to the Feighner criteria for schizophrenia who had been discharged from hospital were traced after 5–9 years. They were assessed in terms of mental state and cognitive, behavioural and neurological functioning; the results of these assessments were related to information obtained from casenotes. The findings of this study of 120 discharged patients were compared with those of an earlier study of 510 in-patients with schizophrenia. When factors of age and duration of illness were taken into account there was no difference between the two groups in terms of positive or negative schizophrenic features or behavioural performance, although the in-patients performed less well on cognitive tests. This study indicates that the deficits of chronic schizophrenia are an integral feature of the disease: process, and that any effects of institutionalisation are relatively small.

Deficits of Chronic Schizophrenia in Relation to Long-Term Hospitalisation

1986 ◽  
Vol 148 (5) ◽  
pp. 509-516 ◽  
Author(s):  
P. John Mathai ◽  
P. S. Gopinath
Keyword(s):  
Mental State ◽  
Hospital Care ◽  
Disease Process ◽  
Chronic Schizophrenia ◽  
Neurological Status ◽  
Social Conditions ◽  
Manic Depressive ◽  
Duration Of Illness ◽  
Current Behaviour

Eighty chronic schizophrenic and 16 manic-depressive psychotic patients conforming to Research Diagnostic Criteria were examined in terms of their mental state, cognitive functioning, current behaviour, and neurological status. They comprised out-patients, day-care patients, and long-stay in-patients belonging to two mental hospitals with different social conditions. Assessed deficits were not significantly related to record variables such as age, duration of Illness, duration of hospitalisation, or treatment received. Analysis of the different groups of patients reveals that long-term hospital care has had little effect on the deficits of chronic schizophrenia, and suggests that these are integral features of the disease process.

The Disabilities of Chronic Schizophrenia—their Nature and the Factors Contributing to their Development

1980 ◽  
Vol 136 (4) ◽  
pp. 384-395 ◽  
Author(s):  
D. G. Cunningham Owens ◽  
Eve C. Johnstone
Keyword(s):  
Patient Care ◽  
Cognitive Functioning ◽  
Present State ◽  
Mental State ◽  
Chronic Schizophrenia ◽  
Neurological Status ◽  
Physical Treatment ◽  
Historical Factors ◽  
Behavioural Performance

SummaryFive hundred and ten patients receiving long-term in-patient care for schizophrenia were examined in terms of their current mental state, cognitive functioning, neurological status and behavioural performance. The abnormalities of these areas of their present state were related to historical factors, personal details, the features of the illness at its worst and physical treatment received. Significant associations between the present state and historical factors were few and mainly concerned time and the features of the illness at its worst. Current abnormalities were not related to past physical treatment, but highly significant correlations were found between the impairments of the four areas of the present state. It is concluded that these impairments are likely to be an integral part of the disease.

Suicide in Chronic Schizophrenia

1982 ◽  
Vol 141 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Alec Roy
Keyword(s):  
Suicidal Ideation ◽  
Patient Care ◽  
Past History ◽  
Chronic Schizophrenia ◽  
Controlled Study ◽  
Chronic Schizophrenic ◽  
Duration Of Illness ◽  
History Of ◽  
History Of Depression

SummaryA matched controlled study of 30 chronic schizophrenic suicides is presented. Eighty per cent were male and committed suicide at a mean age of 25.8 years after a mean duration of illness of 4.8 years. Significantly more of the suicides had a chronic relapsing schizophrenic illness; 23.3 per cent committed suicide while in-patients, and 50 per cent of the out-patients committed suicide within three months of discharge from in-patient care. Significantly more of the suicides had a past history of depression (56.6 per cent), were depressed in the last episode of contact (53.3 per cent), had their last admission for depression or suicidal ideation (55.2 per cent) and were unemployed (80 per cent).

scholarly journals Manualised Cognitive Behaviour Therapy for Anorexia Nervosa: Use of Treatment Modules in the ANTOP Study

2018 ◽  
Vol 7 (11) ◽  
pp. 398 ◽  
Author(s):  
Gaby Resmark ◽  
Brigid Kennedy ◽  
Maria Mayer ◽  
Katrin Giel ◽  
Florian Junne ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Secondary Analysis ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Duration Of Illness ◽  
Cognitive Behavioural ◽  
Outpatient Intervention ◽  
Cognitive Behaviour ◽  
Pros And Cons

Standardised treatment manuals facilitate therapy planning and enhance comparability for research purposes. Within the Anorexia Nervosa Treatment of Out Patients (ANTOP) study, the largest multisite outpatient intervention trial in anorexia nervosa (AN) to date, manualised enhanced cognitive-behavioural therapy (CBT-E) was offered as one treatment modality. The manual consisted of 9 modules, of which Motivation, Nutrition, Formulation and Relapse Prevention were compulsory. Homework worksheets were provided, to ensure the transfer of therapeutic improvements to daily life. This study investigated the use of modules and worksheets in order to explore practice styles of trained therapists in the treatment of AN. This secondary analysis was based on log-sheets (n = 2604) CBT-E therapists completed after each session. Frequencies of modules and worksheets used across all sessions were calculated. Relationships, such as that between use of module and duration of illness, were examined. The most commonly used module was Motivation. In patients with longer illness duration, the module Self Esteem seemed to be particularly important. The worksheet Scales, balancing the pros and cons of AN, was prioritised by therapists. The results underline the importance of motivational work in the treatment of AN, including validating the ambivalence experienced by most AN patients. With increasing duration of illness, resource-oriented elements, such as self esteem stabilisation, should be of focus.

Rate of readmission and mortality risks of schizophrenia patients who were discharged against medical advice

2012 ◽  
Vol 27 (7) ◽  
pp. 496-499 ◽  
Author(s):  
A. Valevski ◽  
G. Zalsman ◽  
S. Tsafrir ◽  
R. Lipschitz-Elhawi ◽  
A. Weizman ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Readmission Rate ◽  
Mortality Rates ◽  
Medical Advice ◽  
Physician Recommendation ◽  
Against Medical Advice ◽  
Improve Outcome ◽  
Mortality Risks ◽  
Duration Of Illness ◽  
Discharged Patients

AbstractPurposeTo compare the readmission and the mortality rates of schizophrenia patients who were discharged against medical advice (AMA) and patients who were discharged by physician recommendation.MethodsThe records (1984–2005) of all consecutive admissions (n = 12,937) of schizophrenia patients (n = 8,052) were reviewed. Out of this group, 673 (8.3%) refused to remain in the hospital and signed a hospital form for discharge AMA. Their records were analyzed for rates of re-hospitalization and mortality at study closure. The records of AMA patients were compared to those of patients with regular discharge (n = 1345).ResultsAMA patients were younger at admission (P<0.001), comprised more males (P<0.01), more were single (P<0.0001), and had a shorter duration of illness than the controls (P<0.05). A total of 49.9% of AMA events occurred within the first 2weeks of hospitalization. The readmission rate was significantly higher for AMA patients than for the controls (P<0.001). The mortality rate as a result of suicide (P<0.0001) and accidents (P<0.05) was higher for AMA patients compared to controls.ConclusionThe schizophrenia patients discharged AMA have a higher readmission rate and a higher mortality rate due to suicide and accidents compared to non-AMA discharged patients. Patients with AMA discharge warrant special community surveillance to improve outcome.

Institutionalization and Perceptual Decrement in Chronic Schizophrenia

1965 ◽  
Vol 21 (1) ◽  
pp. 244-246 ◽  
Author(s):  
Walter J. Johannsen ◽  
Michael J. O'Connell
Keyword(s):  
Chronic Schizophrenia ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Changes ◽  
Duration Of Illness ◽  
Perceptual Changes

Data obtained from a cross-sectional study of perceptual changes in chronic schizophrenia were re-analyzed to determine what effects, if any, institutionalization exerted on perception. When duration of illness was held constant, it was found that schizophrenic Ss with a high percentage of institutionalization time were equivalent to Ss with a low percentage of institutionalization time on three perceptual tasks known to be affected by chronicity. Assertions that psychological changes take place through institutionalization alone are called into question.

Odor Identification Impairments in Schizophrenia: Relationship With Demographic Measures, Clinical Variables, and Diagnostic Subtypes

CNS Spectrums ◽  
2002 ◽  
Vol 7 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Eliza Coleman ◽  
Raymond R. Goetz ◽  
David Leitman ◽  
Scott Yale ◽  
Ariel Stanford ◽  
...  
Keyword(s):  
Disease Process ◽  
Odor Identification ◽  
Gender And Education ◽  
Duration Of Illness ◽  
Psychiatric Hospitalizations ◽  
Clinical Illness ◽  
Relationship Of ◽  
The Relationship ◽  
Smell Identification

ABSTRACTSmell identification deficits are consistently found in schizophrenia (SZ), but little is known about the nature and characterization of this deficit or its relationship to the phenomenology of the illness. This study aims to further delineate smell identification errors in SZ by examining the relationship of patient demographic differences with smell-identification performance. Our results showed that a patient's gender and education were related to odor-identification scores, with better performance seen in female patients and in those with greater educational attainment. However, there was no effect related to age, ethnicity, or socioeconomic status on odor identification. A smell identification deficit was also unrelated to clinical characteristics of the patients, including age at first hospitalization, number of psychiatric hospitalizations, and duration of illness. Odor identification also did not differ by SZ subtype, nor between SZ and schizoaffective disorder patients. These findings emphasize that odor identification deficits in SZ are unrelated to clinical illness features, cannot be explained by other confounds related to olfaction in the general population, and may be core features related to the SZ disease process.

Cognitive-Behavioural Assessment and Treatment of Maladaptive Help-Seeking Behaviour in a Patient with Schizophrenia

2000 ◽  
Vol 34 (4) ◽  
pp. 688-691 ◽  
Author(s):  
Gus Norris ◽  
Roy Laube
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Help Seeking ◽  
Service Providers ◽  
Public Mental Health ◽  
Chronic Schizophrenia ◽  
Cognitive Behavioural ◽  
Public Mental Health Services ◽  
Help Seeking Behaviour

Objective: Maladaptive help-seeking behaviour in psychiatric patients is a significant problem for public mental health services, yet it is not addressed in the mainstream literature. We present a report on the successful treatment of a person with schizophrenia who displayed this common dilemma for patients and clinicians. Clinical picture: A 31-year-old man with borderline intellectual functioning had a 10-year history of schizophrenia marked by negative features. He frequently presented in crisis to public mental health services, the local hospital, and his general practitioner; this resulted in excessive use of services, including admissions. Treatment: The patient was reassessed from a cognitive-behavioural perspective rather than a syndromal perspective. Specific behaviours were modified, cognitions were identified, challenged and restructured, and other service providers were provided with an alternative to admission or acute community care. Outcome: At 24 months the maladaptive behaviour remains in remission. Conclusions: Behavioural problems in persons with chronic schizophrenia may be effectively treated by reconceptualising the behaviour as distinct from the major diagnosis.

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