Prognostic significance of type of onset of mental illness.

A critique of current trends in psychotherapy research.

“…Swensen, Pascal, (23,24) in a series of studies on type of onset and duration of illness as related to outcome, recognize the importance of such controls. They selected from a much larger group two groups of unimproved and improved patients not significantly different on other pertinent variables.…”

“…It is true though that there have been several attempts recently to provide some rationale for the selection of improvement criteria, greater reliance on actual behavior rather than test performance, and in some cases longer duration following the end of therapy. In the Swensen and Pascal studies (23,24), for example, the patient was considered improved if, one year following discharge from the Western Psychiatric Institute, the patient was working at an efficiency comparable to his level prior to becoming sick; he was considered unimproved if he was still in, or had been returned to, a mental institution, or was out of hospital but not performing his regular work in an acceptable manner.…”