The Chronic Patient's Comprehension and Recollection of His Own Clinical Review

¹ Research Assistant, St. Wulstan's Hospital, Malvern, Worcestershire
² Director of Rehabilitation, St. Wulstan's Hospital, Malvern, Worcestershire

A system is described for reviewing the progress of chronic psychiatric patients under rehabilitation. The advice tendered to a sample of 113 patients at their reviews has been recorded and analysed. The patients' ability to recall this advice ranged from 12 per cent-83 per cent (mean 41 per cent). The main clinical factors associated with the patients' performance were IQ and length of illness; no association could be shown with diagnosis or social withdrawal. The patients' performance was distinctly poorer than that of non-patient controls.

If recall performance is in any way affected by the nature of the subject on which advice is offered, or by the technique, status etc. of the staff person offering it, this could not be demonstrated beyond reasonable doubt. The factor swamping everything else was the volume of advice offered. When this was large it led to a smaller percentage recall and vice versa.

From this study three practical points emerge. (1) The mentally disabled person has an impaired grasp of all advice offered to him. (2) This impairment is worse the lower the IQ and the longer the person has been ill, regardless of the amount of time spent in hospital. (3) The number of small topics presented to such a person at one time should not exceed about fifteen.