What is effective in the psychosocial treatment of younger, chronic schizophrenic inpatients? A 10 years follow-up study

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Abstract
In 1973/74, Ugelstad and co-workers performed a treatment project in Gaustad Hospital on a cohort of 30 young, male schizophrenic inpatients. The aim was to investigate the efficacy of four different psychosocial treatment approaches. The cohort was divided into four groups, the two experimental ones receiving individual psychotherapy and group-oriented milieu therapy, the two comparison groups being given occupational rehabilitation and milieu-treatment in an emergency ward unit. The treatment project lasted for fifteen months. At 2 years follow-up, short-term results regarding work activity and independent functioning outside hospital were promising for the experimental groups. This article describes a 10 years follow-up study of the cohort on the basis of the treatment project. The aim was to examine long-term efficacy of the psychosocial treatment approaches applied, primarily in the context of preventing chronification in hospital. Furthermore, we wanted to investigate other critical determinants of long-term prognosis for the actual cohort. The patients were interviewed and examined on different clinical and social parameters. Their subjective experiences of the treatment are described. The most interesting finding was that the two experimental groups, similar at the outset, split apart in regard to psychosocial function, with a clearly better outcome on the psychotherapy group side. The treatment project as such had a limited impact on long-term course in three of the groups. In the psychotherapy group, a clear positive effect of this treatment approach is demonstrated in 4 of 6 patients. For the cohort as a whole, premorbid factors seemed to be of major importance in determining long-term prognosis.

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