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Tijdschrift voor Psychiatrie 26 (1984) 6, 402 - 419

Short report

Chronicity due to functional psychosis

D. Wiersma, R. Giel, A. de Jong, C.J. Slooff

A cohort of 83 patients with a first life time episode of a functional non-affective psychosis was followed-up for a period of three years since the onset of the illness. Chronicity of this type of mental disorder has been characterised in various ways: e.g. by the total time in psychotic episode, the kind and frequency of incomplete remission, the length of stay in hospital, the total time in mental health care and the development of social disabilities. Without doubt, a functional psychosis is often a chronic and sometimes even fatal disorder: 47% of the patients relapsed at least once, 14% was almost continuously psychotic and 6% committed suicide. On average, the patients in the cohort were psychotic for about half the research-period. Only 20% had a complete remission. An important aspect of chronicity appeared to be the social disability as a consequence of psychosis. For most patients the course of the disability is unfavourable.
Unfortunately, the pattern of mental health care often did not fit in with the development of the social disability. Chronic psychotic patients, for example, who were severely disabled received less af tercare compared with other less disabled patients.
Finally, some consequences of these findings for recent policy with regard to the chronically mentally ill patients are discussed.