Pietzcker A
Psychiatr Prax. 1985 Jan;12(1):19-22.
The course of a mental disease is influenced by a multitude of social factors modifying the necessity and efficiency of treatment via drugs, e.g. neuroleptics. The influence of overriding social factors on the course of a disease is demonstrated, employing schizophrenic diseases as an example: Unemployment increases the admission rate of schizophrenics; schizophrenias take a more favourable course in developing countries than in industrialised countries; in the latter category, rural districts are more favourable than the urban regions with major cities. In acute schizophrenia, the healing process is promoted by a clear-cut and well structurised therapeutic environment in the hospital, whereas a loosely knit and permissive environment delays the curative process. Social factors are particularly important in prophylactic neuroleptic long-term treatment designed to prevent relapses; in this connection, special attention is drawn to the importance of emotionalism governing the attitude and behaviour of family members. These social factors influencing the course of the disease make it necessary to supplement drug treatment by suitable measures in the fields of psychotherapy and sociotherapy.
精神疾病的病程受到众多社会因素的影响，这些因素通过药物（如抗精神病药物）改变治疗的必要性和有效性。以精神分裂症为例，说明了首要社会因素对疾病病程的影响：失业会增加精神分裂症患者的入院率；在发展中国家，精神分裂症的病程比工业化国家更有利；在工业化国家中，农村地区比有大城市的城市地区更有利。在急性精神分裂症中，医院中明确且结构良好的治疗环境可促进康复过程，而松散且宽松的环境则会延迟治愈过程。社会因素在旨在预防复发的抗精神病药物长期预防性治疗中尤为重要；在这方面，特别要注意影响家庭成员态度和行为的情感主义的重要性。这些影响疾病病程的社会因素使得有必要在心理治疗和社会治疗领域采取适当措施来补充药物治疗。
