The Camden schizophrenia surveys. I. The psychiatric, behavioural and social characteristics of the severely mentally ill in an inner London health district.

BACKGROUND

The development of appropriate community care requires knowledge of the characteristics of the severely mentally ill.

METHOD

All patients with a broad diagnosis of schizophrenia (n = 528) were identified via key informants within an inner London health district; Feighner and DSM-III-R criteria for schizophrenia were applied. Clinical and social status, psychopathology (Manchester Scale) and problem behaviours (Social Behaviour Schedule) were assessed in a 4:5 representative sample.

RESULTS

Fifty-seven per cent had experienced at least one compulsory admission. Forty-five per cent (excluding long-stay in-patients) had marked positive psychotic symptoms; social isolation and lack of daytime activity was more common than among comparable populations elsewhere. One hundred and eleven (25%) of the non-hospitalised patients were not in contact with specialist services.

CONCLUSIONS

Difficulties in establishing and maintaining a therapeutic alliance between patients and professionals present a challenge to services in inner London. Many social and occupational needs were not being met by existing community provision.