Hospital and outpatient care for psychotic patients during the last three decades. Subsequent hospital and outpatient treatment of psychotic patients hospitalized for the first time in 1949--50, 1959--60 or 1969--70.

The study deals with the development in the extent of hospital treatment and trends concerning outpatient visits for psychotics in Turku hospitalized for the first time in 1949--50 (period of shock therapy), 1959--60 (period of neuroleptics) or 1969--70 (period of intensified outpatient treatment). The bed capacity for psychiatric patients increased in Turku in the 1950-s, but has declined slowly since then. The number of hospitalized cases nevertheless continued to rise up to the 1970's. The number of caretaking personnel in the outpatient sector has increased five-fold and the extent of outpatient visits 20-fold over the 25 years covered by the study. After the introduction of neuroleptics, first hospitalizations became shorter, as fewer and fewer patients remained in long-term hospital treatment. At the same time the annual extent of hospital treatment declined, whereas rehospitalizations became more frequent. Along with intensified outpatient treatment first hospitalizations became still shorter, but the total need for hospital treatment was not reduced. During intensified outpatient treatment, rehospitalization was rapid and, at first, frequent; subsequently rehospitalizations became less frequent compared to the period of neuroleptics. In the 1970's intensive outpatient treatment provided immediately after the first hospital stay appears to be most clearly associated with a reduction in the number of hospital treatment days of schizophrenics. In the case of psychoses of old age an increased extent of outpatient treatment did not lead to a decline in the need for hospital treatment.