Towards comprehensive care in schizophrenia

Abstract

The care of schizophrenic patients involves many difficulties. We do not have any etiological treatment, because the etiology of schizophrenia is still unknown. On the other hand, the course of the illness is determined not only by the clinical picture but also by the previous development of patients and by many actual stress factors. We thus need a broader approach than the one based on symptoms only.

This article is based chiefly on experiences from two follow-up studies. A total of 175 schizophrenic patients were interviewed by the author an average of 8 years after their first admission. More than one third of the patients had been treated in a psychotherapeutic community and one fifth had received sustained psychotherapy. All others had received traditional treatment.

During the first follow-up years, the patients treated in the psychotherapeutic community had spent longer in the hospital and their functional capacity was lower, but their attitude to the treatment they had received was more favourable than that of the traditionally treated patients. There were some problems involved in the transition of patients' treatment from the inpatient to outpatient setting, and the need for rehabilitation was much greater than the amount provided. Results are discussed in greater detail from the socio-psychiatric point of view. □ Schizophrenia, comprehensive care, follow up-studies.