A 15-year Followup of 646 Schizophrenic Outpatients

Abstract

The 15-year hospitalization course of 646 chronic schizophrenic outpatients treated between 1958 and 1963 was determined using records of the research clinic, the Kings County Psychiatric Hospital, and the New York State Department of Mental Hygiene. The cohort was heterogeneous with regard to previous history of hospitalization: 20.6 percent had never been hospitalized, 22.0 percent had experienced only crisis admissions, and 57.4 percent had experienced long-term psychiatric hospitalization. The results indicate that 58.8 percent were hospitalized subsequent to project entry. A relationship was observed between previous history and hospitalization and hospitalization during the followup period. Patients with no previous history of hospitalization was less likely to be hospitalized than patients with crisis admissions only, who in turn were less likely to be hospitalized than patients with a history of hospitalization in a long-term psychiatric treatment facility (39.1 percent vs. 53.5 percent vs. 67.9 percent; p less than .001). The implications of these findings for future followup studies are discussed.

The epidemiology of onset and course of schizophrenia

“…Our analyses revealed that operationalising the longterm course of schizophrenia by means of inpatient treatment data only (Eaton et al 1992a;1992b;Engelhardt et al 1982) does not seem to be sufficient. As can be deduced from our juxtaposition of treatment data and illness indicators at different times, it seems that with increasing illness duration more and more also psychotic symptoms and exacerbations may be treated by outpatient measures.…”

Relationship of activity and morale levels to institutionalization among aging schizophrenics

“…The results indicate that male schisophrenic veteran out-patients score higher than a sample of institutionalized schizophrenics on morale and activity, a finding that is substantiated in other studies (Engelhardt et al, 1982;. It is important to note that the with more education and better health reported higher morale than did those with less education and who felt less healthy.…”

“…In addition to concerns about housing appropriateness, questions frequently arise about the quality of life for the patient discharged from a psychiatric hospital . Now that the feasibility of discharging chronioally mentally ill patients from hos pitals is established (Engelhardt et al, 1982), it is time for an evaluation of the quality of life being experienced by the deinstibutionaliaed mental patient. The demographic and health related variables were selected because of other studies ) that have documented the relationship of these vari ables to measures of quality of life among deinstitutionalaliaed schizophrenics.…”

“…A replication of the study with a non-veteran population would help determine if the level of out patient care being received by this group may have had a significant impact on their adjustment to the oommunity. A number of studies have indicated that deinstitutionalized schizophrenics often do not receive the level of care that they need (Engelhardt et al, 1982; and that is a factor in the poor adjustment sometimes reported for the deinstitutional ized schizophrenic. It would also be useful to follow up on the subjects reported on in this study.…”

Nonregressive schizophrenia ‐ a long‐term comparative follow‐up investigation

“…An overview of Table 2 shows that over 80% of all patients required repeated and at times prolonged periods of inpatient care. The figures are prevailingly high in comparison with other long-term follow-up studies of chronic schizophrenic patients (30)(31)(32)(33). A majority of the patients were indeed rehospitalized within the first 5-year period and half of them in fact within the first 2 years after first discharge.…”