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Life Events and Schizophrenic Relapse after Withdrawal of Medication

Published online by Cambridge University Press:  02 January 2018

Joseph Ventura ,
Keith H. Nuechterlein ,
Jean Pederson Hardesty  and
Michael Gitlin
Joseph Ventura*
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA
Keith H. Nuechterlein
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA
Jean Pederson Hardesty
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA
Michael Gitlin
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA
*
∗UCLA Department of Psychiatry and Biobehavioral Sciences, 300 Medical Plaza, Suite 2200, Los Angeles, CA90024-6968, USA
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Abstract

Research with schizophrenic out-patients has shown that antipsychotic medication reduces relapse rates. This protective factor may operate partially by raising the threshold for relapse in the face of environmental stressors such as life events and high levels of familial expressed emotion. A prospective, longitudinal design was employed in the monthly collection of life-events data with 23 recent-onset schizophrenic out-patients. In a between-subjects ANOVA, a significantly higher frequency of independent life events was found in the month prior to a relapse for ten patients on medication, as compared with the analogous month for 13 drug-free patients. These findings suggest that neuroleptic medication may produce a prophylactic effect by raising a patient's threshold of vulnerability to relapse.

Type
Papers
Information
The British Journal of Psychiatry , Volume 161 , Issue 5 , November 1992 , pp. 615 - 620
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Birley, J. L. T. & Brown, G. W. (1970) Crisis and life changes preceding the onset or relapse of acute schizophrenia. British Journal of Psychiatry, 116, 327–333.CrossRefGoogle ScholarPubMed
Brown, G. W. & Birley, J. L. T. (1968) Crisis and life change and the onset of schizophrenia. Journal of Health and Social Behavior, 9, 203–214.CrossRefGoogle Scholar
Brown, G. W. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241–258.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. (1978) Social Origins of Depression. New York: Free Press.Google ScholarPubMed
Curson, D. A., Barnes, T. R. E., Bamber, R. W., et al (1985) Long-term maintenance of chronic schizophrenic out-patients: the seven-year follow-up of the Medical Research Council fluphenazine/placebo trial. British Journal of Psychiatry, 146, 464–480.CrossRefGoogle ScholarPubMed
Day, R., Nielsen, J. A., Korten, A., et al (1987) Stressful life events preceding the acute onset of schizophrenia: a cross-national study from the World Health Organization. Culture, Medicine and Psychiatry, 11, 123–205.CrossRefGoogle ScholarPubMed
Dohrenwend, B. S., Krasnoff, L., Askenasy, A. R., et al (1978) Exemplification of a method for scaling life events: the PERI life events scale. Journal of Health and Social Behavior, 19, 205–229.CrossRefGoogle ScholarPubMed
Goldstein, M. J. (1987) Psychosocial issues. Schizophrenia Bulletin, 13, 157–171.CrossRefGoogle ScholarPubMed
Hogarty, G. E., Goldberg, S. C., Schooler, N. R., et al (1974) Drug and sociotherapy in the aftercare of schizophrenic patients: II. Two-year relapse rates. Archives of General Psychiatry, 31, 603–608.CrossRefGoogle ScholarPubMed
Hogarty, G. E. & Ulrich, R. F. (1977) Temporal effects of drug and placebo in delaying relapse in schizophrenic outpatients. Archives of General Psychiatry, 34, 297–301.CrossRefGoogle ScholarPubMed
Jacobs, S. & Myers, J. (1976) Recent life events and acute schizophrenic psychosis: a controlled study. Journal of Nervous and Mental Disease, 162, 75–87.CrossRefGoogle ScholarPubMed
Kanner, A. D., Coyne, J. C., Schaefer, C., et al (1981) Comparison of two modes of stress measurement: daily hassles and uplifts versus major life events. Journal of Behavioral Medicine, 4, 1–39.CrossRefGoogle ScholarPubMed
Leff, J. P. (1987a) A model of schizophrenic vulnerability to environmental factors. In Search for the Causes of Schizophrenia (eds H. Häfner, W. F. Gattaz & W. Janzarik), pp. 317–320. Berlin: Springer-Verlag.CrossRefGoogle Scholar
Leff, J. P. (1987b) The influence of life events and relatives' Expressed Emotion on the course of schizophrenia. In Psychopathology: An International Perspective (eds D. Magnusson & A. Öhman), pp. 59–76. New York: Academic Press.Google Scholar
Leff, J. P., Hirsch, S. R., Gaind, R., et al (1973) Life events and maintenance therapy in schizophrenic relapse. British Journal of Psychiatry, 123, 659–660.CrossRefGoogle ScholarPubMed
Leff, J. P., Kuipers, L., Berkowitz, R., et al (1983) Life events, relatives' Expressed Emotion and maintenance neuroleptics in schizophrenic relapse. Psychological Medicine, 13, 799–806.CrossRefGoogle ScholarPubMed
Lukoff, D., Nuechterlein, K. H. & Ventura, J. (1986) Manual for the Expanded Brief Psychiatric Rating Scale (BPRS). Schizophrenia Bulletin, 12, 594–602.Google Scholar
Nuechterlein, K. H. (1987) Vulnerability models for schizophrenia: state of the art. In Search for the Causes of Schizophrenia (eds H. Häfner, W. F. Gattaz & W. Janzarik), pp. 297–316. Berlin: Springer-Verlag.CrossRefGoogle Scholar
Nuechterlein, K. H. & Dawson, M. E. (1984) A heuristic vulnerability/stress model of schizophrenia episodes. Schizophrenia Bulletin, 10, 300–312.CrossRefGoogle ScholarPubMed
Nuechterlein, K. H., Snyder, K. S., Dawson, M. E., et al (1986) Expressed Emotion, fixed-dose fluphenazine decanoate maintenance, and relapse in recent-onset schizophrenia. Psychopharmacology Bulletin, 22, 633–639.Google ScholarPubMed
Nuechterlein, K. H., Dawson, M. E., Ventura, J., et al (1991) Testing vulnerability models: stability of potential vulnerability indicators across clinical state. In Search for the Causes of Schizophrenia, vol. 2 (eds H. Häfner & W. F. Gattaz), pp. 177–191. Heidelberg: Springer-Verlag.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799–812.CrossRefGoogle Scholar
Spitzer, R. L., Endicott, J. & Robbins, E. (1978) Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Vaughn, C. E. & Leff, J. P. (1976) The influence of family and social factors on the course of psychiatric illness: a comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry, 129, 125–137.CrossRefGoogle ScholarPubMed
Vaughn, C. E., Snyder, K. S., Jones, S., et al (1984) Family factors in schizophrenic relapse: a California replication of the British research on Expressed Emotion. Archives of General Psychiatry, 41, 1169–1177.CrossRefGoogle ScholarPubMed
Ventura, J., Nuechterlein, K. H., Lukoff, D., et al (1989) A prospective study of stressful life events and schizophrenic relapse. Journal of Abnormal Psychology, 98, 407–411.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and CATEGO Program. London: Cambridge University Press.Google Scholar
Zubin, J. & Spring, B. (1977) Vulnerability–a new view of schizophrenia. Journal of Abnormal Psychology, 86, 103–126.CrossRefGoogle ScholarPubMed
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