Abstract
A total 501 of in-and outpatients with schizophrenia have been directly observed for over 10 years at Karasuyama Mental Hospital affiliated with Showa University as of Sept. 20, 1979, in which, actual status has been investigated and analyzed for 68 cases, while excluding those patients over 55 years old, graft schizophrenia, and robotomy-treated cases out of 134 inpatients admitted for over 17 years. Accordingly, discussion was made on the effect of psychiatric rehabilitation at Karasuyama Mental Hospital for 20 years for long-term hospitalized patients. Also, simultaneous discussion was made on the countermeasures and treatments hereafter for these patients. In view of the psychiatric symptoms and social adaptability, long-term admitted inpatients showed the significantly unfavourable symptoms than those of the population (501 cases), and also, decrease of values in behavioral rating scale was significant. That is, when the prognosis was divided into symptomatic groups, namely, unfavourable, intermediate and favourable cases, they are composed of one group as“nucleus”showing the unfavourable prognosis and intermediate group, thus it may be called“intractable group”. The present subjects are remaining cases“result”under the psychiatric rehabilitation system in Karasuyama Mental Hopital, while as compared with the symptoms 10 years ago in view of the clinical progress, unchanged symptom was most numerously observed, followed by the“improvement”and“aggravation”. As a whole, mutual“offset”is observed with the“unchanged symptom”as center, thus no significant difference was observed on the mean value of the obtained points for behavioral rating scale. Whereas, by the existence of one group showing the improving tendency at least, the effect of psychiatric rehabilitation cannot be neglected, and especially, this tendency was more markedly observed in the execution-cases of night hospital (N.H.), on the other hand, its change remained within the frame of the defective image as a result of chronic symptoms. The current subjects have already been receiving the treatments by the application of the Government's or other social insurance systems in almost all cases. At any rate, it is necessary to take countermeasures for protection hereafter as to the treatments of long-term hospitalized patients, especially. It is important to make applications in the phase of welfare. Moreover, even though the major point placed with importance in the therapy in psychiatric clinic has been moved to the rehabilitation and community care, there is still no fundamental solution for the prognosis and the clinical progress of schizophrenia, therefore, it is necessary to pay full attention to one group as shown in the present subjects.
