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Author Eaton, William W. ♦ Ham, Josep M. ♦ Bo, Herrman Preben ♦ Freeman, Mortensen Hugh ♦ Burgess, Philip
Source CiteSeerX
Content type Text
File Format PDF
Subject Domain (in DDC) Computer science, information & general works ♦ Data processing & computer science
Subject Keyword Part Ii ♦ Progressive Deterioration Implies ♦ Ultimate Outcome ♦ Hospital Episode ♦ Treatment Ca-reer ♦ Progressive As-pect ♦ Long-term Followup Data ♦ Additional Episode ♦ Overall Chronidty ♦ Dsm-iii State ♦ Fu-ture Episode ♦ Com-mon Course ♦ Residual Impair-ment ♦ Psychiatric Case Regis-ters ♦ In-dividual Return ♦ Shift-like Schizophrenia ♦ Time Pass ♦ Large Proportion ♦ De-terioration Accelerates ♦ Hospitalization Occur ♦ Defined Cohort ♦ Progressive Amelio-ration ♦ First Hospitalization ♦ Natural Course ♦ Hospital-ization Lower ♦ Little Analysis ♦ Progressive Deterioration ♦ Acute Exacerba-tions ♦ Schizo-phrenic Patient ♦ Initial Episode
Abstract This analysis examines the notion of progressive deterioration in schizo-phrenia, using long-term followup data on hospital episodes in defined cohorts from psychiatric case regis-ters in Victoria, Australia; Denmark; and Salford, England. The analyses differentiate heterogeneity existing at the first hospitalization for schizo-phrenia, which produces a widely varying natural course, from hetero-geneity that develops over time, as episodes of hospitalization occur. Episodes of hospitalization for schizophrenia tend to duster earlier rather than later in the treatment ca-reer, suggesting a progressive amelio-ration rather than deterioration. When overall chronidty is adjusted, each additional episode of hospital-ization lowers the risk for a further hospitalization by about 10 percent. Kraepelin's work seemed to imply that a large proportion of schizo-phrenic patients would progressively deteriorate over the years following their initial episode (Kraepelin 1919/1971). Progressive deterioration implies that the ultimate outcome is unfavorable and that the rate of de-terioration accelerates over time. There has been much controversy as to whether ultimate outcome is unfa-vorable or not (Harding et al. 1987; Westermeyer and Harrow 1988) but little analysis of the progressive as-pect of the course. The notion of progressive deterioration implies that the rate at which episodes occur speeds up as time passes and that the level of functioning to which the in-dividual returns upon remission from a given episode is progressively lower, and the probability of a fu-ture episode higher, than before the episode. The shift in level of func-tioning is portrayed in Ciompi's drawings of typologies of course (Ciompi 1980) and is part of the con-cept of "shift-like " schizophrenia (Shmaonova et al. 1983). The DSM-III states that the "most com-mon course is one of acute exacerba-tions with increasing residual impair-ment between episodes " (emphasis
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Research
Education Level UG and PG ♦ Career/Technical Study