The influence of previous hospitalization on the clinical course of psychopharmacologically treated schizophrenic outpatients

Abstract

Summary Our study has demonstrated that the biographical factor of history of hospitalization is a meaningful predictor of the clinical course of schizophrenic outpatients. Active ataractic therapy (chlorpromazine and promazine) interacts with history of hospitalization to produce different qualities of treatment outcome. For patients with a history of previous hospitalization and prone to rehospitalization, active drug therapy significantly reduces this tendency. For patients “not previously hospitalized” and not prone to hospitalization active drug therapy tends to improve the quality of social behavior. The introduction of the concept of history of hospitalization as an organizing point appears to be clinically and methodologically rewarding. History of hospitalization describes a significant aspect of the patient's past, it represents a potent factor influencing the patient's future clinical course, it significantly interacts with ataractic therapy and it also reflects the patient's ongoing adaptation in the community. In our study, history of hospitalization was found to be independent of our indices of psychopathology. The variable thus must be considered an important aspect of the schizophrenic patient's adaptation to his illness not reflected in the usual mental status examination of the patient. It is suggested that in the long term study of psychopharmacological outpatient therapy, the biographical dimension of history of hospitalization may prove to be a meaningful way of classifying the ambulatory schizophrenic patient.