Brief Hospitalization and Aftercare in the Treatment of Schizophrenia

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Abstract
A total of 201 schizophrenic men were randomly assigned to one of three groups: (1) standard hospital care with discharge at physician's discretion and normal VA care; (2) accelerated hospital care for 21 days and treatment by the same staff on an outpatient basis for one year; and (3) standard hospital treatment followed by the aftercare program given group 2. The brief-treatment group showed as much sustained improvement as those who stayed longer. The longer-stay groups tended to be more symptomatic than the brief-treatment group after three weeks but less symptomatic at their discharge. Both intensified aftercare groups manifested less pathological disturbance at 12 months. The short-stay group did not demonstrate a greater incidence of readmission or a shorter mean time out of the hospital prior to first readmission. There was little evidence of the superiority of one group over another with respect to community adjustment. ONE OF the more significant trends in modern psychiatric treatment involves moving the hospitalized patient out as soon as socially disturbing symptoms are under control. The availability of psychotropic agents and vast experience in their use, accompanied by a reinvigorated concept of the therapeutic role of the hospital, have made it possible to provide treatment in such fashion. A profusion of aftercare facilities reflect the increased attention being paid to outpatient care as a support for posthospital adjustment.1,2 A priori, a short hospital stay allows the patient to maintain his ties to the outside world.