Johnstone E C, Owens D G, Gold A, Crow T J, Macmillan J F
Br J Psychiatry. 1984 Dec;145:586-90. doi: 10.1192/bjp.145.6.586.
A cohort of 120 patients, comprising all those who met the St Louis criteria for a diagnosis of schizophrenia, discharged from a mental hospital over a five-year period, were followed-up in the community after an interval of five to nine years; 105 were traced and 94 were alive. Of those, 66 were living in UK, out of hospital, and willing to be seen. Their mental states, and social functioning and circumstances were assessed by interview with the patients and those with whom they lived; 18% had recovered to the extent that they had no significant symptoms and appeared to function satisfactorily. More than 50% had definite psychotic features. No patients and few relatives sought a return to hospital care, but severe emotional, social, and financial difficulties were commonplace; 27% of the sample had no contact with medical or social services, a further 14% saw only community nurses, and 24% only their general practitioners. The findings emphasise the limitations of community services in dealing with the chronicity and severity of the impairments resulting from schizophrenic illness.
一个由120名患者组成的队列,包括所有符合圣路易斯精神分裂症诊断标准的患者,他们在五年内从一家精神病院出院,经过五到九年的间隔后在社区接受随访;105人被追踪到,94人还活着。其中,66人住在英国,不住院,愿意接受检查。通过与患者及其同住者面谈,对他们的精神状态、社会功能和生活状况进行了评估;18%的患者已经康复到没有明显症状且功能似乎令人满意的程度。超过50%的患者有明确的精神病特征。没有患者和很少有亲属寻求回到医院治疗,但严重的情感、社会和经济困难很常见;样本中有27%的人没有与医疗或社会服务机构接触,另有14%的人只见过社区护士,24%的人只见过他们的全科医生。这些发现强调了社区服务在应对精神分裂症所致损伤的慢性和严重性方面的局限性。