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Article
April 1968

The Intermittent PatientHis Reference Groups and Intergroup Tensions

Author Affiliations

Pittsburgh; Denver
From the Western Psychiatric Institute, University of Pittsburgh School of Medicine, Pittsburgh (Dr. von Mering), and the Staff Development Department, Fort Logan Mental Health Center, Denver (Dr. Schiff).

Arch Gen Psychiatry. 1968;18(4):400-404. doi:10.1001/archpsyc.1968.01740040016003
Abstract

IN CONSIDERING possible reasons for the chronicity of patients with schizophrenic reactions or other forms of serious mental illnesses, and with particular attention to the difficulties in their being discharged from treatment settings and being maintained in the community, many authors have considered such factors as metabolic dysfunctions, intrapsychic and interpersonal deficits, and/or adverse influences of the patient's milieu, whether it be familial, cultural, vocational, or others. We propose that particular transactions between patients and various elements of their total milieu may contribute to the problem of the intermittent1 or chronic patient, and that these transactions may be relevant regardless of, and along with, other etiologic considerations. Our intent is to describe several group, intergroup, and system phenomena which may contribute to the understanding of the patient's lack of movement and inability to respond to treatment.

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