Present Treatment of Schizophrenia--a Controlled Follow-up Study

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Abstract
The results of a two-year follow-up of 39 schizophrenic patients treated mainly with insulin coma are compared with 84 schizophrenics treated since the introduction of phenothiazines. Of the "insulin-treated" group, 31% were in hospital and 51% were rated as psychotic at follow-up, compared with 7% in hospital and 26% psychotic of the "phenothiazine-treated" group. The methods of selection, the environment, and the general treatment setting were the same for both groups. Very little if any detailed psychotherapy was found necessary, and in only a few cases was special rehabilitation needed. The average length of stay has also been reduced, from 10.7 to 6.7 weeks. The percentage of patients rated as "symptom-free" has not, however, been increased by phenothiazines; the improvement has been confined to a shift from the "psychotic" to the "residual symptom" group, probably in part due to the strictness of our criteria for recovery. Details are given of the change in the pattern of treatment of schizophrenia in a general hospital psychiatric unit over the past 13 years. It is suggested that a major revolution has occurred in the treatment possibilities of this illness, which can now also be carried out so easily in a general rather than a mental hospital setting. Skilled handling of the physical treatments is most important, with a determination to use every combination of treatments likely to help any individual patient.