Psychological symptoms: The importance of assessing health status

A comprehensive treatment program for schizophrenia and chronic mental illness

The failure of deinstitutionalization and the community mental health movement to improve the treatment of chronic psychiatric patients, particularly schizophrenics, is described. Problems with the current treatment paradigm include unrealistic expectations concerning the rehabilitative effects of antipsychotic medications, inadequate funding of the community mental health system, and the predominance of the "infectious disease model," rather than the more appropriate "chronic disease model" of mental illness. A model for the comprehensive treatment of chronic mental illness is proposed that includes: treatment, rehabilitation, social services, and continuity of care. The need for an integrated community approach to rehabilitating chronic psychiatric patients is stressed, and some of the specific ingredients essential to such a program are identified.

Drugs, lifestyle, and health: a longitudinal study of urban black youth

The association of drug use with indicators of health status was studied in a representative sample of urban Black youth interviewed first in adolescence and then six to seven later in young adulthood. Seven substances, with interaction terms as appropriate, were tested against a psychophysical health scale and also against a more inclusive general health scale. Both measures of health outcomes yielded similar findings. Earlier inhalants use and, under certain conditions, methadone were linked to health change in males. Heroin had a delayed relationship to females' health. Additionally, methadone was associated with poorer health among young Black women who also were heavy alcohol drinkers. The observed relationships between drug use and health persisted after introducing controls for associated lifestyle factors.