SOCIAL FIELD EVENTS DURING THE FIRST WEEK OF HOSPITALIZATION AS PREDICTORS OF TREATMENT OUTCOME FOR PSYCHOTIC PATIENTS

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Abstract
This study of 24 acutely psychotic patients suggests that clinical outcome at the time of discharge from the hospital and at follow -up evaluation 1 year after admission can be partially predicted either from case history variables (e.g., type of onset) or from evaluation of certain social field variables measured during the 1st week of the patient''s hospitalization. The social field variables were aloneness, i.e., the percentage of unstructured time the patient spent alone, staff anger toward the patient, and staff liking for and optimism toward the patient[long dash]attitudes rated during the 1st week of hospitalization. Good outcome at discharge was strongly associated with high staff liking and optimism and low staff anger. Good outcome at 1 year was strongly associated with the presence of favorable case history variables (e.g., the onset was acute and clear precipitants were present) and with a high initial level of socialization (low aloneness score); there was also a significant association with high staff liking and optimism and low staff anger. Discharge status was highly correlated with functional status at 1 year after admission. This fact and the relationship of initial staff attitudes to discharge status suggest that the therapeutic community achieved appreciable success in establishing continuity between the gains made within the therapeutic milieu and the patients" lives in the outside world.

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