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Schizophrenia's defining trends.

Many psychiatrists regard the introduction of antipsychotic medication in the 1950s as a boon for the long-term adjustment of people with schizophrenia, a devastating disturbance of thought and emotion. But an analysis of research conducted over the past century indicates that psychiatric definitions of schizophrenia, rather than new treatments, primarily account for observed improvements or declines in the condition of schizophrenics over time.

James D. Hegarty of McLean Hospital in Belmont, Mass., and his colleagues identified 359 studies from the United States, Europe, Russia and China in which scientists used specific criteria to diagnose schizophrenia in 15 or more individuals and then tracked the patients' progress for at least one year.

At least 15 percent of the schizophrenics studied from 1900 to 1930 showed significant improvement, Hegarty's team contends. That figure rises to 30 percent between 1930 and 1970 and then declines to about 15 percent again in research covering the past 20 years, they say. Studies in the first and last time periods generally used narrow definitions of schizophrenia, often requiring continuous signs of distrubance for at least six months. Projects in the middle period relied on broader definitions with no minimum time limits on symptoms.

"In studies from 1930 to 1970, more patients got better because they had milder problems to begin with," Hegarty maintains.

The poorer outcome for schizophrenics studied after 1970 may also reflect the discharge of many patients from state mental hospitals and the lack of community mental health care for people with severe psychiatric disorders, he adds.
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Author:Bower, Bruce
Publication:Science News
Article Type:Brief Article
Date:May 16, 1992
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