Continued engagement with schizophrenia patients can prevent declines

From Clinical Psychiatry News, 23 April 2013:

A review of the causes and impact of hospitalization in schizophrenia has shown that hospitalization is more likely the result of cognitive and functional decline rather than a contributor.

“While it is difficult to disentangle the consequence of the reasons for hospitalization from the effects of hospitalization, most contemporary hospitalizations are extremely brief, and the cause is typically psychotic exacerbation or aggressive and hostile behavior,” wrote Philip D. Harvey, Ph.D., and his colleagues at the University of Miami.

“It is important to know whether being treated in a hospital, for either the short or long term, is an antecedent or consequence of clinical symptoms, cognitive deficits, and disability.”

Historically, patients with schizophrenia were institutionalized in hospitals for long periods of time, but that changed with the introduction of chlorpromazine as treatment in the mid-1950s. This led to the discharge of a significant proportion of patients from long-stay care and changed the model of care for schizophrenia.

“Further, the entire inpatient treatment model for schizophrenia has changed drastically, from stays that averaged 6-12 weeks for “acute admissions” 25 years ago, to 5- to 7-day stays or even admissions that are not designated as admissions because the patient stays in the emergency room for up to 72 h,” the authors reported (Neurobiol. Dis. 2013;53:18-25). Read more.

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