Institutionalization and the defects of schizophrenia.

Patients conforming to the Feighner criteria for schizophrenia who had been discharged from hospital were traced after 5-9 years. They were assessed in terms of mental state and cognitive, behavioural and neurological functioning; the results of these assessments were related to information obtained from casenotes. The findings of this study of 120 discharged patients were compared with those of an earlier study of 510 in-patients with schizophrenia. When factors of age and duration of illness were taken into account, there was no difference between the two groups in terms of positive or negative schizophrenic features or behavioural performance, although the in-patients performed less well on cognitive tests. This study indicates that the deficits of chronic schizophrenia are an integral feature of the disease process, and that any effects of institutionalisation are relatively small.