Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T18:29:56.091Z Has data issue: false hasContentIssue false

Institutionalization and the Defects of Schizophrenia

Published online by Cambridge University Press:  29 January 2018

Eve C. Johnstone
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ
D. G. Cunningham Owens
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ
Aviva Gold
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ
T. J. Crow
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ
J. Fiona Macmillan
Affiliation:
Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ

Summary

Patients 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.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1981 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Affleck, J. W., Burns, J. & Forrest, A. D. (1976) Long-term follow up of schizophrenic patients in Edinburgh. Acta Psychiatrica Scandinavica, 53, 227–37.Google Scholar
Barton, R. (1959) Institutional Neurosis. Bristol: John Wright.Google Scholar
Blackwell, B. (1973) Drug Therapy. Patient Compliance. The New England Journal of Medicine, 289, 249–52.Google ScholarPubMed
Bland, R. C. & Orn, H. (1978) Fourteen-year outcome in early schizophrenia. Acta Psychiatrica Scandinavica, 58, 327–38.Google Scholar
Brown, G. W. (1959) Social factors influencing length of hospital stay of schizophrenic patients. British Medical Journal, ii, 1300–2.Google Scholar
Brown, G. W., Bone, M., Dalison, B. & Wing, J. K. (1966) Schizophrenia and Social Care. London: Oxford University Press.Google Scholar
Donnelly, E. F., Weinberger, D. R., Waldman, I. N. & Wyatt, R. J. (1980) Neuropsychological prediction of structural brain abnormalities on computed tomography in a group of chronic schizophrenic patients. Journal of Nervous and Mental Disease, 168, 305–8.Google Scholar
Feighner, J. P., Robins, E., Guze, S., Woodruff, R. A., Winokur, G. & Munoz, R. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 5762.Google ScholarPubMed
Gardos, G., Cole, J. O. & Tarsy, D. (1978) Withdrawal syndromes associated with antipsychotic drugs. American Journal of Psychiatry, 135, 1321–4.Google ScholarPubMed
Golden, C. J., Moses, J. A., Zelazowski, R., Graber, B., Zatz, L. M., Horvath, T. B. & Berger, P. A. (1980) Cerebral ventricular size and neuropsychological impairment in young chronic schizophrenics. Archives of General Psychiatry, 37, 619–23.Google ScholarPubMed
Kendell, R. E., Brockington, I. F. & Leff, J. P. (1979) Prognostic implications of six alternative definitions of schizophrenia. Archives of General Psychiatry, 36, 2531.Google ScholarPubMed
Kety, S. S. (1959) Biochemical theories of schizophrenia. Science, 129, 1528–32.Google ScholarPubMed
Krawiecka, M., Goldberg, D. & Vaughan, M. (1977) Standardised psychiatric assessment scale for chronic psychotic patients. Acta Psychiatrica Scandinavica, 55, 299308.Google ScholarPubMed
Mann, S. & Cree, W. (1975) The ‘new long stay’ in mental hospitals. British Journal of Hospital Medicine, 14, 5663.Google Scholar
Martin, D. (1955) Institutionalisation. Lancet, ii, 1188–90.Google Scholar
Myerson, A. (1939) Theory and principles of the ‘total push’ method in the treatment of chronic schizophrenia. American Journal of Psychiatry, 95, 1197–204.Google Scholar
Owens, D. G. C. & Johnstone, E. C. (1980) The disabilities of chronic schizophrenia—their nature and the factors contributing to their development. British Journal of Psychiatry, 136, 384–95.Google Scholar
Renfrew, S. (1967) An Introduction to Diagnostic Neurology (Second Edition). Edinburgh: Livingstone.Google Scholar
Rieder, R. O., Donnelly, E. F., Herdt, J. R. & Waldman, I. N. (1979) Sulcal prominence in young chronic schizophrenic patients: CT scan findings associated with impairment on neuropsychological tests. Psychiatry Research, 1, 18.Google Scholar
Stephens, J. H., Ota, K. Y., Carpenter, W. T. & Shaffer, J. W. (1980) Diagnostic criteria for schizophrenia prognostic implications and diagnostic overlap. Psychiatry Research, 2, 112.Google ScholarPubMed
Wing, J. K. & Brown, G. W. (1970) Institutionalism and Schizophrenia. London: Cambridge University Press.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Withers, E. & Hinton, J. (1971) Three forms of the clinical tests of the sensorium and their reliability. British Journal of Psychiatry, 119, 18.Google ScholarPubMed
World Health Organization (1979) Schizophrenia: an International Follow-up Study. Chichester: John Wiley.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.