Dickey B, Gudeman J E, Hellman S, Donatelle A, Grinspoon L
Hosp Community Psychiatry. 1981 May;32(5):326-30. doi: 10.1176/ps.32.5.326.
Twenty-seven chronically ill mental patients were followed up four years after their discharge from a state hospital to the Massachusetts Mental Health Center. In interviews with the patients and their caregivers, data were gathered on the patients' current places of residence, mental status, time spent in the hospital since discharge, levels of functioning, and quality of life. The authors found that patients tended to move from hospital to community, with rehospitalization dropping dramatically once patients were placed in the community; that the group of patients living in the community had a better average mental status; that all but two patients preferred their current living situations to life at the state hospital; and that the best predictor of community residence was age at first admission (over 20). Two policy issues are discussed: the relationship (or lack of one) between restrictiveness and type of residence, and the importance to the findings of changes in psychiatric practice over the lifetime of the sample.
27名慢性病精神患者从州立医院出院四年后，被随访至马萨诸塞州心理健康中心。在对患者及其护理人员的访谈中，收集了有关患者当前居住地、精神状态、出院后住院时间、功能水平和生活质量的数据。作者发现，患者倾向于从医院转移到社区，一旦患者被安置在社区，再次住院的情况就会大幅下降；居住在社区的患者群体平均精神状态更好；除两名患者外，所有患者都更喜欢他们目前的生活状况，而不是在州立医院的生活；社区居住的最佳预测因素是首次入院时的年龄（超过20岁）。讨论了两个政策问题：限制程度与居住类型之间的关系（或缺乏这种关系），以及样本生命周期内精神病学实践变化对研究结果的重要性。
