Adjustment of Schizophrenics in the Community

1. Front Matter

   Pages i-xi

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2. A Critical Appraisal of the Current State of Knowledge in Schizophrenia

   • George Serban

   Pages 1-16

3. Design and Procedures of the Schizophrenia Research Project: Subjects; Measures; and General Methods of Statisical Analysis

   • George Serban

   Pages 17-60

4. Value of Sociodemographic Data for Prediction of Outcome in Schizophrenia

   • George Serban

   Pages 61-80

5. Comparison of Functioning Levels of Schizophrenics and Normals, Implications for Short-Term Prediction of Rehospitalization of Schizophrenics

   • George Serban

   Pages 81-102

6. The Measurement of Stress in Schizophrenics and Normals in Community Living

   • George Serban

   Pages 103-121

7. Comparison of Two Classifications of Schizophrenia: Acute-Chronic and High-and-Low Competent on Comprehensive Functioning and Stress Derived From the SSFIPD

   • George Serban

   Pages 123-135

8. Genetic and Developmental Factors as Related to Stress in Schizophrenia

   • George Serban

   Pages 137-161

9. The Validity of Diagnostic Signs and Their Prognostic Value in Schizophrenia

   • George Serban

   Pages 163-186

10. Motivation in Schizophrenics and Normals

    • George Serban

    Pages 187-203

11. Adjustment of Schizophrenics in the Community

    • George Serban

    Pages 205-233

12. Prognosis in Schizophrenia as Related to Treatment

    • George Serban

    Pages 235-262

13. Back Matter

    Pages 251-294

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The mental health movement of early release into the community of the chronic schizophrenic has been based on a set of old theoretical assumptions and expectations which, when tested on the community level, failed to meet the desired results. On the contrary, the first visible outcome of deinstitutionalization was the revolving door policy with the patients repeatedly in and out of the hospital, changing their previous status of inpatient to the new one of pseudoam­ bulatory. Yet, this would not be a serious problem if the life of the patient in the community, in between rehospitalizations, was beneficial to him and to the community. However, the quality of life experienced by the patients in the community appears to be deplorable. Available statistics indicate that over 70% of chronic schizophrenics discharged into the community live a marginal, unproductive, aimless life in dilapidated hotels or private proprietary homes. Certainly, though there are various scattered community programs for the rehabilitation of the schizophrenic, the results are far from encouraging. With these basic facts in mind, we have to ask ourselves: What went wrong with deinstitutionalization? Apparently in the process of hasty deinstitutionaliza­ tion, too many issues were overlooked by the community mental health planners. The most critical factor neglected by the policy makers was the establishment of more realistic criteria for the patient who can or cannot function in the community.

• Motivation
• quality of life
• rehabilitation
• schizophrenia
• stress
• treatment

• New York University Medical School, USA

  George Serban

• New York University-Bellevue Medical Center, USA

  George Serban

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