Day Treatment and Psychotropic Drugs in the Aftercare of Schizophrenic Patients

TLDR

The study randomized 10 hospitals’ schizophrenic patients at discharge to day treatment plus medication or medication alone, assessing social functioning, symptoms, attitudes, community tenure, and costs at baseline and at 6‑24 months, while documenting center process variables every six months. Results showed that while all centers improved social functioning, only six centers significantly delayed relapse, reduced symptoms, and altered attitudes, with no cost difference versus medication alone; centers with high staff hours, group therapy, and high turnover performed poorly, whereas those with more occupational therapy and a sustained nonthreatening environment achieved better outcomes.

Abstract

• Schizophrenic patients referred for day treatment at the time of discharge from ten hospitals were randomly assigned to receive day treatment plus drugs or to receive drugs alone. They were tested before assignment and at 6, 12, 18, and 24 months on social functioning, symptoms, and attitudes. Community tenure and costs were also measured. The ten day centers were described on process variables every six months for the four years of the study. Some centers were found to be effective in treating chronic schizophrenic patients and others were not. All centers improved the patients' social functioning. Six of the centers were found to significantly delay relapse, reduce symptoms, and change some attitudes. Costs for patients in these centers were not significantly different from the group receiving only drugs. More professional staff hours, group therapy, and a high patient turnover treatment philosophy were associated with poor-result centers. More occupational therapy and a sustained nonthreatening environment were more characteristic of successful outcome centers.