No abstract

The ever-increasing number of chronic neuropsychiatric patients represents perhaps the foremost problem in the field of mental health today. Despite recent advances, notably in the fields of chemotherapy and rehabilitation, the burden of the chronic population grows, threatening to overwhelm existing hospital facilities and available professional personnel. This study was conceived as the first step in a three-part plan to: (a) develop an index predictive of chronicity; (b) attempt to isolate and study the determinants of chronicity; and (c) develop and test the effectiveness of retraining programs based on the defining characteristics of the chronic population.The possibility of a predictive index was suggested by a study previously completed at the Perry Point Veterans Administration Hospital (Giedt & Schlosser, 19SS). An analysis of the time sequence of discharge rate for the patient population revealed that 61% of admitted patients left the hospital during the first 90 days, 25% during the next IS months, and only 2% during the remaining 24 months covered by the study. A predictive index, based on demographic characteristics ascertainable at the time of hospital admission, would permit a comparison of the 1 The authors wish to acknowledge their indebtedness to John L. Holland, Albert Pepitone, and Richard Sanders for their contributions in the original formulation of this study.

"Rate of recovery from tuberculosis was estimated for 46 patients by the amount of time required for bacteriological conversion to occur. This criterion was then correlated with 4 classes of psychological measures. Variability in rate of recovery from tuberculosis was found to be associated with adaptive behavior on the ward, associated to some degree with measures of fantasy, and unrelated to expressed attitudes or to prehospital behavior, as measured. A cluster of positive correlations was then derived from the total matrix, and hypotheses offered concerning personality "syndromes' associated with fast recovery and slow recovery from tuberculosis."