Factors influencing community adjustment of discharged long-term schizophrenic patients

Aborigines, colonizers and newcomers: the landscape of transcultural psychiatry research in Australia

The authors present an analysis of transcultural psychiatry research in relation to three main population groups in Australia: Aboriginal Australians, documented immigrants, and refugees. The pioneering reports produced by Western psychiatrists in Aboriginal communities are examined in this article. Additional quantitative and qualitative studies developed with Aboriginal people in the context of a traumatic acculturation process are also reviewed. Subsequently, the authors examine the challenges faced by immigrants with mental disorders in a health care system still unequipped to treat a new array of clinical presentations unfamiliar to the clinical staff. The authors also highlight the development of policies aimed at providing quality mental health care to a mosaic of cultures in an evolving multicultural society. Lastly, the psychiatric manifestations of refugees and asylum seekers are analysed in the context of a series of vulnerabilities and deprivations they have experienced, including basic human rights.

[Ecologic factors and risk of rehospitalization of psychotic patients]

The present study investigates the relationship between ecological factors and the community tenure patients with functional psychoses. Data were gathered from the records of three psychiatric hospitals in the city of Hamburg. The analysis controls for the effects of sociodemographic variables and variables pertaining to the last impatient treatment. Variations in readmission rates can be explained by the latter to a certain extent, but only poorly by sociodemographic variables and hardly at all by ecological factors. These findings are discussed with respect to the methodological limitations of the study and as substantive results. Two lines of interpretation are offered. Firstly, equal readmission rates may have been caused by different sets of ecological factors; secondly, patients released from mental hospital may be relatively insusceptible to the impact of ecological factors.

On factors complicating rehabilitation of psychiatric patients

Judging by previous studies, the factors most seriously complicating the rehabilitation of psychiatric patients include the underdeveloped state of society, the symptoms and detrimental consequences of the patients' disorders, the harmful consequences of prolonged institutionalization and the problems associated with home and family.

The sample of this study consisted of 104 patients who were under treatment at the University Psychiatric Clinic, Helsinki, on November 30, 1971. No old people or children were included. The subjects' educational and intellectual levels were above average, and the proportion of patients with grave disorders in the sample was smaller than in psychiatric hospitals in general. The sample included no addicts.

The attending doctor filled out, for each subject, a questionnaire, on which information was provided about the subject's psychosocial background, recommendations made for his treatment and rehabilitation, and the most serious obstacles to his rehabilitation were assessed. A number of “recommendation” and “obstacle” alternatives were listed in the form, from which 4 and 5 respectively of the most important were chosen.

The patients' psychic disorders, problems associated with their families and homes, unrealistic hopes and expectations, and lack of motivation proved the most serious obstacles to rehabilitation. Typical of all these is their somewhat individual-centred nature. They were apparently linked with the reasons why the patients had come to hospital for treatment and with the rehabilitational goals the respondents had had in mind. Obstacles that can be characterized as social were of little significance, housing problems being the only exception here. The authors feel that caution should be observed in drawing generalized conclusions from these results, because the results of studies on rehabilitation are in general closely tied up with the population or sample studied as well as the environment and society.

Sociopsychiatric study of schizophrenia: the follow-up

SYNOPSIS A one-year follow-up of 127 schizophrenic patients admitted to psychiatric hospitals in 1968–69, who had spent at least three months in the community during the year following their admission, revealed that regular taking of medication is the most crucial single factor leading to improvement in the psychiatric status of the patient, regardless of whether he was living in a positive or a negative environment. No difference was found between family of origin and nuclear family, but family setting tended to influence either improvement or deterioration of the patient, whilst patients living in a non-family setting remained predominantly unchanged. The progress of southern European patients was poorer than all the others, independently of their family setting and medication.