EFFECT OF LENGTH OF HOSPITALIZATION ON RATE AND QUALITY OF REMISSION FROM ACUTE PSYCHOTIC EPISODES

Abstract

In this study the hospital treatment of 2926 schizophrenic patients was reviewed. The rate of discharge from the hospital to the community was 76 percent regardless of the number of days the patient spent in the hospital. The rate of return during a 2-year follow-up period was 20. 5 percent and did not vary with the number of days spent in the hospital during the index hospitalization. The longer the patient stayed in the hospital during the index hospitalization, the longer he tended to stay in the hospital if he required rehospitalization. The longer he stayed in the hospital during the index hospitalization, the less likely he was to function socially and at work at the same or a better level compared to the prehospitalization period. These observations raise serious questions as to the present conceptualization of the hospital as a method of treatment in the schizophrenic patient. When these observations are added to the recognition that long-term hospitalization produces problems of dependency and dysfunction which go far beyond those produced by the disease process, it is quite appropriate to question the value of long-term hospitalization in the treatment of the chronic psychotic patient. In brief hospitalization with brief rehospitaliza-tions becoming the rule rather than the exception, many facilities could be converted to treatment centers which provide partial care (day care, night care, outpatient care, after care) thus preventing the iatrogenic total alienation of the patient from society by total hospitalization.