Department of Psychiatry II, Ulm University, Günzburg, Germany.
Neuropsychobiology. 2012;66(1):70-5. doi: 10.1159/000338549. Epub 2012 Jul 13.
Eugen Bleuler, in his book Dementia praecox oder Gruppe der Schizophrenien, discussed issues of social psychiatry, and he considered complex interventions pivotal in the care for people with schizophrenia. Bleuler emphasised the potential of therapeutic communities in providing care, the drawbacks of extended hospitalisation and the therapeutic potential of planned 'early discharge' and job integration.
Some of the current evidence on therapeutic communities, planned early hospital discharge, alternatives to inpatient care and job integration in people with severe mental illness are reviewed.
(i) Current evidence suggests that therapeutic communities (and new forms of milieu therapy, e.g. Soteria) are an effective ingredient of care; (ii) the evidence on planned early discharge suggests that there is scope for early discharge if continuity of care is ensured, and (iii) the evidence on supported employment suggests that there is scope for early job placement/supported employment among people with schizophrenia with little risk to clinical stability.
Eugen Bleuler was a far-sighted social psychiatrist who concentrated on treatment issues and complex interventions that are considered cornerstones of care for people with severe mental illness one hundred years later.
Eugen Bleuler 在他的著作《早发性痴呆或精神分裂症群》中讨论了社会精神病学的问题，他认为复杂的干预措施是精神分裂症患者护理的关键。Bleuler 强调了治疗社区在提供护理方面的潜力、延长住院治疗的弊端以及有计划的“早期出院”和工作融入的治疗潜力。
本文回顾了一些关于严重精神疾病患者的治疗社区、计划提前出院、替代住院治疗和工作融入的当前证据。
（i）现有证据表明，治疗社区（和新形式的环境治疗，如 Soteria）是护理的有效组成部分；（ii）关于计划提前出院的证据表明，如果确保了连续性护理，提前出院是有空间的；（iii）关于支持性就业的证据表明，对于精神分裂症患者，在临床稳定风险很小的情况下，提前安置工作/支持性就业是有空间的。
Eugen Bleuler 是一位有远见的社会精神科医生，他专注于治疗问题和复杂的干预措施，这些措施被认为是一百年后严重精神疾病患者护理的基石。
