Schizophrenic Veterans Research Articles

Premorbid adjustment in schizophrenia: iImplications for psychosocial and ventricular pathology

Premorbid adjustment in schizophrenia is thought important (1) as a predictor of current pathology and course, and (2) as a psychosocial expression of brain pathology preceding psychosis. Its valid and reliable measurement, however, pose a major challenge. To address this issue we interviewed 12 chronic male schizophrenic veterans and their first degree relatives, plus 12 age and social class of origin matched normal controls and their relatives, using the Cannon-Spoor et al. Premorbid Adjustment Scale (PAS), for which we developed our own semi-structured interview. Objective data from school records were also obtained. Schizophrenic's PAS scores were significantly poorer, irrespective of whether PAS scores were based on information from subjects, first degree relatives or from ‘combined sources’. PAS scores were worse at all developmental epochs, with a marked divergence beginning in late adolescence. Worse premorbid adjustment in schizophrenia was also highly correlated with current clinical state, more current negative symptoms, less independent living and longer duration of hospitalization. Additionally, worse premorbid adjustment in schizophrenia was associated with larger Magnetic Resonance (MR) Ventricular Brain Ratio (VBR) in an exploratory analysis using a subset of these patients. Premorbid adjustment, rigorously measured, is poorer in schizophrenics than in normal controls and correlates with psychosocial and ventricular pathology in schizophrenia.

Positive and Negative Symptoms of Schizophrenia as Predictors of Length of Military Service: A Retrospective Study

Forty-three chronic schizophrenic veterans had negative symptom, positive symptom, and smooth pursuit eye movement evaluations to determine if the severity of impairment in these dimensions could retrospectively predict their length of military service. For the entire patient group, there was a strong trend for severity of negative symptoms to predict the length of military service (p = 0.055). However, different associations for these variables emerged when the patients were divided into groups with more or less than 2 years of service. The length of military service might serve as a type of "filter" that meaningfully separates out different subtypes of schizophrenic veterans.

Race and treatment of schizophrenic veterans

Race and treatment of schizophrenic veterans

Life stress and ecological status: predictors of symptoms in schizophrenic veterans.

Maintaining schizophrenic clients in the community has been a goal of the health care system since the late 1960s. In an attempt to determine factors that may precipitate an onset of psychiatric symptoms and should thus be targeted in efforts to achieve the goal of community care, this study of a sample of schizophrenic veterans used multivariate analysis to identify markers of clients' vulnerability.

Vietnam and Madness: Dreams of Schizophrenic Veterans

1. Vietnam veterans who still suffer from post-traumatic stress and delayed-stress disorders may respond to psychotherapy. Dreams that have recurred as often as every night for 8 to 15 years may be depotentiated. 2. In the records of the Vietnam veterans whom I have seen on my ward, almost without exception there has been no documentation of the contents, frequency and nature of their dreams and nightmares, and no precise record of their military experience in Vietnam. 3. By creating special group therapy, a Dream Seminar, and by individual analytical psychotherapy, a way has been found to work with these dreams as part of the post-traumatic stress disorder. 4. Three case histories have been presented to highlight the nature of these dreams and how they may respond to therapy. 5. In a larger perspective, the dreams of Vietnam offer a unique record of the unconscious history of Vietnam, uncontaminated by the waking ego, by conscious motivations or distortions. There cases have led to an extensive in-depth study of 125 randomly selected Vietnam combat veterans, which will be reported later. 6. Combat dreams recurring in identical form for years may change and evolve in a therapeutic drama.

Nailfold capillary plexus and familial schizophrenia.

This was an effort to repeat in a controlled experiment Marieq's findings that the normally invisible subpapillary plexus was visible in more familial than nonfamilial schizophrenics. Newly admitted white male schizophrenic veterans were given detailed physical and mental examinations, including a blind evaluation of the relative visibility of the nailfold plexuses. Although the familial schizophrenics had more visible plexuses than the nonfamilial ones, the difference was small. The two categories were compared on 46 variables relating to background, mental status, treatment status, and physical condition with almost no positive results. The demonstrated difference in the nailfold plexuses seems to be of little nosological value.

Relation of reduction in compensation to rehospitalization.

Utilizing data from claims files, a sample of 97 schizophrenic veterans who had a reduction in disability compensation was studied over a 10-yr. follow-up period. Rehospitalizations were noted and compared against compensation reductions. It was assumed that, if reduction of compensation were a factor in rehospitalization, the veteran would return to the hospital around the effective date of reduction. Only 10 veterans were found to have any hospitalization within 3 mo. of the effective date of reduction. Contrary to expectation, it was further found that veterans who had received a notice of compensation reduction stayed out of the hospital significantly longer than those not so notified. Also, veterans who appealed the impending reduction of their compensation were less frequently rehospitalized than veterans who did not appeal. No significant relationships were found between rehospitalization within 3 mo. of reduction and per cent or dollar amount of reduction, age, marital status, or person with whom the veteran was living when compensation was reduced.

EMPLOYMENT EXPERIENCE AMONG 200 SCHIZOPHRENIC PATIENTS IN HOSPITAL AND AFTER DISCHARGE.

A measure of work and work-like activity during hospitalization of 211 male schizophrenic veterans was compared with their posthospital employment experience over a 6-month follow-up period. Most of the patients (53%) had participated in worthwhile, constructive activity on a regular basis during at least part of their hospitalization. However, less than half of the sample (47%) were employed at any time after their return to the community. Of those who sought and obtained employment, only 49 (or approximately one-fifth of the original sample) worked at a regular full-time job throughout the follow-up period. The need for much greater use of special employment centers and/or placement is suggested by these findings.

Differential Treatment and Prognosis in Schizophrenia.

This volume is a monographic extension of an earlier report (Am. J. Psychiat. 114:1077, 1958) with an amplification of the sections devoted to survey of the literature, methodology, tabulations of data, and discharge and follow-up results. The original report summarizes the data well, and the justification for the monograph appears to lie in the documentation of the methodological problems and limitations of psychopharmacologic research. After a critical survey of the relatively few “controlled” drug evaluation studies between 1954 and 1956, the authors carefully delineate their problem—a comparative study of the efficacy of reserpine and chlorpromazine in previously untreated, male schizophrenic veterans. Patients were selected on clinical criteria and randomly assigned to one of four treatment groups: chlorpromazine, reserpine, clinical judgment (any treatment, including chlorpromazine or reserpine), and hospital routine (no specific somatic or psychotherapies). The specific treatment was administered for four weeks, and thereafter all patients were assigned to