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January 1967

Phenothiazines in Prevention of Psychiatric Hospitalization: IV. Delay or Prevention of Hospitalization—A Reevaluation*

Author Affiliations

From the Psychopharmacology Research Unit, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn.

Arch Gen Psychiatry. 1967;16(1):98-101. doi:10.1001/archpsyc.1967.01730190100013

THIS PAPER is the fourth in a series of investigations into the factors influencing hospitalization of schizophrenic outpatients. In the first publication it was shown that chlorpromazine had a marked effect in reducing the incidence of hospitalization among ambulatory chronic schizophrenic Patients.1 Further exploration revealed that although chlorpromazine was highly effective early in treatment, its effectiveness diminished progressively over time, suggesting delay rather than prevention of hospitalization. In contrast to phenothiazine-treated patients, the hospitalization rates for groups of patients treated with placebo were similar, regardless of duration of treatment exposure.2 A review of the literature found a similar consistency in the hospitalization rates reported for placebo-treated patients (25% to 30%),2 suggesting the existence of a finite subgroup of "hospitalization prone" patients in any given group of ambulatory schizophrenic patients. In addition, the consistency in the hospitalization rates of placebo-treated groups suggests