Adaptive disability: some precipitating factors in schizophrenic decompensation.

Abstract

Many schizophrenics are able to go through life without ever breaking down. They remain, however, characteristically vulnerable to all modifications of their more-or-less precarious mental status quo. Should their social or emotional equilibrium be perturbed, they are apt to break down. In the foregoing discussion of adaptive disability, the authors have described three categories of changes in life situations that are likely to bring about decompensation of a hitherto adequately functioning schizophrenic. In the first group some well-known noxious changes, such as loss of a loved person, a disease, an accident, were reviewed. The second category is composed of changes that are usually regarded as beneficial by normal individuals but which may paradoxically precipitate a mental breakdown in schizophrenics and are therefore called “quasi-favorable.” Job promotion, fulfillment of wishes, recovery of a sick relative, or achievement of goals can be a boon to the normal person, but a blow to the schizophrenic. In the last category the authors describe the hazards of coercive psychiatric treatment, whether psychotherapy or chemotherapy, which can increase the pathological way of life of compensated schizophrenics as their defenses are broken down.