Social outcome after first admission for schizophrenia in Tasmania

Summary

In a comparative study of social outcome and admission to hospital in patients with schizophrenia, 24 first-discharged schizophrenics were individually matched with 24 first-discharged patients with neurosis or personality disorder on the sociodemographic variables of age, sex, marital status and occupational level. Matching was complete according to our criteria in 19 pairs. Both groups were followed up and personally interviewed. Five areas of social adjustment were assessed on a predetermined scale: accommodation, employment, family relations, social contacts and management of finances. Adjustment in each area was recorded as the presence or absence of (1) a severe problem which had occurred after discharge whether or not resolved; and (2) a severe unresolved problem. Overall ratings based on the number of problem areas showed significant differences between the groups in both the number of severe problems experienced after discharge and in the number of unresolved problems. Schizophrenics had had significantly more severe problems than controls in employment and social contacts, but had more unresolved problems in family relations and social contacts. It appeared that difficulties in housing were common to both groups, that schizophrenics initially had more employment problems than controls but to a considerable extent overcame them, and that family and social relationships constituted major and persisting problems only for the schizophrenics. Both the number of re-admissions and the total duration of rehospitalisation were much greater in schizophrenics than controls, and the differences were far larger than could be accounted for purely by the difference in social adjustments as measured in the present study.