Deficits of Chronic Schizophrenia in Relation to Long-Term Hospitalisation

Mathai, Paul; Gopinath, P. S.

doi:10.1192/bjp.148.5.509

Cited by 19 publications

(6 citation statements)

References 17 publications

(4 reference statements)

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“…It has been suggested that negative symptoms (Crow, 1980) and thought disorder (Carpenter et al, 1988) are enduring and do not respond to neuroleptics or to change in environment (Crow, 1980;Mathai and Gopinath, 1985); at first sight, this appears to have been supported by the findings in this study. It must be remembered, however, that the environment in which these patients were living was relatively stable, at least as compared to that in the 'active' rehabilitation wards or the community.…”

Section: Discussioncontrasting

confidence: 46%

“…In previous studies (Owens and Johnstone, 1980;Johnstone et al, 1985;Mathai and Gopinath, 1985;Wagman et al, 1987;Carpenter et al, 1988;Harris et al, 1992), the incidence of deficit symptoms has varied considerably depending on the nature of the sample and the methods of assessment. Our samples of elderly and younger schizophrenic patients showed a high frequency and severity of negative and disorganization symptoms.…”

Section: Discussionmentioning

confidence: 99%

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The elderly chronic schizophrenic inpatient: A study of psychiatric morbidity in ‘elderly graduates’

Soni

Mallik

1993

Int J Geriat Psychiatry

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SUMMARYThis study surveyed all chronic schizophrenic patients from I 1 long-stay wards of a mental hospital. Patients were assessed on a variety of rating scales to assess clinical psychopathology and behaviour. Patients above the age of 65 years were studied in detail and also compared with those under that age living on the same wards. It was found that all the elderly schizophrenic patients in the sample had severe deficits in the form of residual negative symptoms and thought disorder. They had significantly fewer positive but more negative symptoms as compared to a younger sample on the same wards; there was no differences between the groups for affective symptoms or thought disorder. Although there were more males in the sample, no difference was found on any of the parameters between the two sexes. It was concluded that there are significant clinical differences in the 'elderly graduates' as compared to younger patients living in an identical environment; such findings could assist managers and administrators in the development of plans for other patients in this age group who are likely to be relocated from psychiatric hospitals in the near future or are already living in the community.

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Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

The elderly chronic schizophrenic inpatient: A study of psychiatric morbidity in ‘elderly graduates’

Soni

Mallik

1993

Int J Geriat Psychiatry

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“…Although we do not have specific data, there is little reason to believe that our subject groups differ significantly on these factors. Further support for the use of the MMSE in this research comes from its use in similar settings elsewhere (Harvey et al, 1992b;Mathai and Gopinath, 1985;Wilkin and Jolley, 1979).…”

Section: Discussionmentioning

confidence: 97%

“…However, comparing outpatient and inpatient samples of schizophrenic subjects, Johnstone et al (1 98 1) concluded that the severe cognitive deficits they found were more likely due to the disease process than the circumstances of its treatment. Subsequent research has reinforced a lack of association between length of illness and cognitive deficit in schizophrenia (Harvey eta!., 1992;Mathai and Gopinath, 1985). Other research suggests that identifiable cognitive deficits may predate schizophrenia onset (Cornblatt and Erlenmeyer-Kimling, 1985) and are present even during periods of relative remission (Asarnow and MacCrimmon, 1978;Harvey et al, 1990).…”

Section: Discussionmentioning

confidence: 99%

The taps project. 21: Functional and organic comorbidity and the effect of cognitive and behavioural disability on the placement of elderly psychiatric inpatients—a whole‐hospital survey

Anderson

Trieman

1995

Int J Geriat Psychiatry

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SUMMARYThis article reports a survey by the Team for the Assessment of Psychiatric Services (TAPS)* of all inpatients aged 70 years or more resident in Claybury Hospital, London, for more than 12 months. Age, sex, total length of inpatient stay and type of care received were recorded for each subject. and assessments using the Mini-Mental State Examination (MMSE) and Modified Crighton Royal Behavioural Rating Scale (MCRBRS) were performed. Of 189 inpatients who completed the assessments, 142 (75%) showed unequivocal, severe cognitive disability (MMSE < 17). Patients were assigned to 'functional', 'organic' or 'mixed' diagnosis groups by staff report and case note review. A staff report of 'mixed' diagnosis missed a large number of patients who had an original diagnosis of functional psychiatric disorder plus severe measured cognitive disability. Sixty-five per cent of patients with an original diagnosis of functional psychiatric disorder fell into this category. AFter controlling for age, sex and total length of inpatient stay, patients with a severe degree of reported behavioural problems (MCRBRS 2 17) were almost 23 times (95% CI 6.6-79.4) more likely to receive specialized psychogeriatric care than other patients. Severe cognitive disability was not associated with type of care received. Issues related to measurement of cognitive disability across disparate diagnostic groups are discussed. KEY woRDs4lderly mentally ill; dementia; schizophrenia; comorbidity; cognitive disability; behavioural disability Despite government policy supporting the closure of psychiatric hospitals, little is known about the disabilities of long-stay elderly mentally ill (EMI) inpatients and the alternative services necessary to provide for their care in the community. Suggestions for optimal care are available (Blessed, 1988;Murphy, 1992) and some innovative pilot projects report beneficial outcomes upon resettlement (Dean et al

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“…Prevention of prolonged inpatient stay is advocated by many as potentially therapeutic and feasible with adequate community support (Bland et al ., ; Caton, ; Gorecka and Czernikiewicz, ; Malone et al ., ; Tasic et al ., ). In contrast, other investigators (Johnstone et al ., ; Mathai and Gopinath, ) suggest that long‐term hospital care itself has adverse effect on the social deficits in chronic schizophrenia and that long‐term patients show distinctive features of a protracted disease process that are not caused by hospitalization. Rossler et al ., () suggested that it is not the location of care that influences symptom patterns and social functioning, but rather the amount of social and especially family support that is provided in different settings.…”

Section: Introductionmentioning

confidence: 99%

Long‐ and short‐term inpatients with schizophrenia in China: Implications for community‐based service development

Ouyang

Yang

et al. 2012

Asia-Pacific Psychiatry

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Introduction There is an increasing interest in the patterns of mental health care of people with serious mental illnesses in China, where outpatient and community‐based care are not fully developed and long‐term hospitalization is still not uncommon. Comparison of sociodemographic and clinical characteristics of long‐term and short‐term inpatients diagnosed with schizophrenia can be informative about pattern of treatment and their relationship to services needs. Methods Seventy‐three long‐term schizophrenia inpatients (current length of stay of more than 5 years) were compared to 116 short‐term schizophrenia inpatients (current length of stay of 30 days or less) assessed with the Individual Background Questionnaire, the Positive and Negative Syndrome Scale (PANSS) and the Social Support Rating Scale (SSRS). Results There was no significant difference between the groups on the total PANSS symptom score but the short‐term inpatients scored significantly higher than their long‐term counterparts on the Positive Syndrome sub‐scale and the SSRS and lower on the Negative Syndrome sub‐scale. Discussion Differences in symptomatology and social functioning may be related to better medication adherence and more extended social isolation among long‐term inpatients while the increased positive symptoms are likely to reflect more acute disease process in short‐term inpatients, and possibly poorer medication adherence. These differences may be especially pronounced in developing countries like China in which community‐based services need to be more fully developed to facilitate medication adherence and prevent relapse, and to support community adjustment of socially isolated patients who otherwise require hospitalization.

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Deficits of Chronic Schizophrenia in Relation to Long-Term Hospitalisation

Cited by 19 publications

References 17 publications

The elderly chronic schizophrenic inpatient: A study of psychiatric morbidity in ‘elderly graduates’

The elderly chronic schizophrenic inpatient: A study of psychiatric morbidity in ‘elderly graduates’

The taps project. 21: Functional and organic comorbidity and the effect of cognitive and behavioural disability on the placement of elderly psychiatric inpatients—a whole‐hospital survey

Long‐ and short‐term inpatients with schizophrenia in China: Implications for community‐based service development

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