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August 1957

A Prognostic Indicator of Treatment Failure in Schizophrenia

Author Affiliations

Catonsville, Md.

AMA Arch NeurPsych. 1957;78(2):177-193. doi:10.1001/archneurpsyc.1957.02330380067010

Introduction  In the population of any large mental hospital one frequently encounters patients diagnosed according to one of the typical nosological classifications of schizophrenia who, in spite of numerous therapeutic efforts on the part of medical personnel, maintain a stationary clinical course. Such patients neither regress to a more primitive state nor show any appreciable improvement during extensive periods of interrupted or continuous hospitalization. Although they display few, if any, regressive phenomena in the integration of their thinking, they can adjust adequately only to benign environments, a fact that is readily apparent from the frequency of their readmissions. These patients are resentful of hospitalization, claim they are not mentally sick, and seem from the beginning to have and maintain a negativistic attitude toward any attempts at treatment. Since the families of such patients have tremendous difficulty in coping with the patients' usual bizarre modes of living, they exert a great

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