Clinical course and social outcome in schizophrenia. Results from a retrospective study

OBJECTIVE: The aim of the present study is to investigate the possible clinical and symptomatological determinants of social outcome in schizophrenic patients. METHOD: 40 schizophrenic patients (DSMIII-R), 21 males and 19 females, mean age 4 +/- 5 years, have been evaluated in the present retrospective study. All of them had first undergone psychiatric hospitalization between 1978 and 1981. The following data have been collected: socio-anagraphic features and course of the illness (AMDP), contacts with community health centre and pharmacological compliance. Social disability has been investigated by means of a semi-structured interview developed from the "Disability Assessment Schedule" named "Accertamento Disabilita e Carico Familiare" (ADC), which has been administered to the main carer, usually a cohabitant relative. Presence and level of social support have also been evaluated. One Way Analysis of Variance (ANOVA), "t" test with Bonferroni correction and Pearson Correlation test have been used for data analysis. RESULTS: Patients with less severe social disability (lower scores at ADC) were mainly those with recurrent course of illness without residual symptoms or remitted ones (p = 0.0001), better pharmacological compliance (p = 0.004), more frequent and regular contacts with community health centres (p = 0.0001) and better social support (p = 0.01). On the contrary, score at ADC resulted positively correlated with number of hospitalizations (r = 0.57, p = 0.01), number of compulsory admission (r = 0.32, p = 0.01) and length of illness (r = 0.40, p = 0.01). CONCLUSIONS: Although in our study the influence of severity of illness on social disability has been confirmed, suggestive evidence about importance of other factors, such as compliance or social support, may be drawn.