Assessment of needs for care among patients with schizophrenic disorders 15 and 17 years after first onset of psychosis

Abstract

Severe and long term mental disorders, like schizophrenia, show in general a wide range of psychiatric signs and symptoms, psychological and physiological impairments and social disablement (Shepherd, 1994; Wing, 1982) reflecting a variety of mental health needs. Many studies provide only a cross-sectional view of the clinical and social problems of the patient population, for example at intake or admission to a mental hospital. Longitudinal studies following patients after discharge for some period of months or years show in general the expected improvement of functioning (e.g. Nienhuis et al., 1994), but as far as only chronic patients are concerned such a positive change is much less noted. The concept of chronicity of mental disorders would presume that after some time needs are fairly predictable and stable and do not change much over time. Our investigation on the long-term course of schizophrenia (Wiersma et al., 1996; 1997) enables us to study over a period of two years, from 15 to 17 years since first onset of psychosis, the stability or variability of needs in schizophrenic disorder. We are not aware of empirical studies on changes in needs among patients with long-term disorders.

Components of a modern mental health service: a pragmatic balance of community and hospital care

“…Although vocational rehabilitation has been offered in various forms to people with severe mental illness for over a century, its role has weakened because of discouraging results, financial disincentives to work and pessimism about outcomes for these patients (Lehman et al , 1995; Polak & Warner, 1996; Wiersma et al , 1997). However, recent alternative forms of occupation and vocational rehabilitation have again raised employment as an outcome priority.…”