Implications of Drug Treatment for the Social Rehabilitation of Schizophrenic Patients

The psychopathology of schizophrenia, characterized by dramatic manifestations such as hallucinations, delusions, and bizarre posturing, has tended to blind us to the more prevalent and disabling psychosocial aspects of this chronic disorder. Traditional treatment, which has focused primarily on symptom modification and removal of the patient from the community, has failed to affect the patient's impaired social and vocational functioning. Schizophrenic patients released from hospitals have generally not been successful in maintaining themselves in the community. Rehospitalization rates have indicated that between 40 and 60 percent of schizophrenic patients discharged from hospitals will be rehospitalized within 2 years (Mosher et al. 1971) and 65 to 75 percent by the end of 5 years (Anthony et al. 1972). The disruption caused by hospitalization (Fontana and Dowds 1975) may account for the fact that only between 15 and 40 percent of schizophrenic patients living in the community are able to support themselves (Anthony et al. 1972 and Mosher et al. 1971). The direct as well as indirect costs to our society for the care of the 2 to 3 million Americans carrying a diagnosis of schizophrenia have been estimated by Gunderson and Mosher (1975) " . . . at $11.6 to $19.5 billion annually. About two-thirds of this cost is due to lack of productivity by schizophrenic patients and about one-fifth to treatment costs" (p. 901).