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The Maine and Vermont Three-Decade Studies of Serious Mental Illness

II. Longitudinal Course Comparisons

Published online by Cambridge University Press:  02 January 2018

Michael DeSisto*
Affiliation:
Bureau of Mental Health, State of Maine, Augusta, Maine
Courtenay M. Harding
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT
Rodney V. McCormick
Affiliation:
Department of Medical Biostatistics
Takamaru Ashikaga
Affiliation:
Department of Medical Biostatistics
George W. Brooks
Affiliation:
Department of Psychiatry, College of Medicine, University of Vermont, Burlington, VT, USA
*
Dr Michael DeSisto, Outcomes, Inc., 18 Sheldon Street, Farmingdale, ME 04334, USA

Abstract

Background

This paper supplements the cross-sectional outcome comparisons of the companion paper by providing a brief account of the longitudinal courses of the Maine and Vermont samples across several outcome domains.

Method

A Life Chart method was used to document changes in individual lives over the domains of residence, work, income source, and use of community resources over a 20-year period. Reliability studies between states were conducted.

Results

Throughout much of the period, more Vermont subjects lived independently, were working, and were less likely to use community resources compared to Maine subjects.

Conclusions

Differences in both policies and programmes contributed to course differences between the groups. System characteristics that may lead to better outcomes are discussed.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists

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References

American Psychiatric Association (1968) Diagnostic and Statistical Manual of Mental Disorders (2nd edn) (DSM–II). Washington, DC: APA.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Angst, J. (1988) European long-term followup studies of schizophrenia. Schizophrenia Bulletin, 14, 501513.10.1093/schbul/14.4.501Google Scholar
Anthony, W. A., Buell, G. J., Sharratt, S., et al (1972) Efficacy of psychiatric rehabilitation. Psychological Bulletin, 78, 447456.10.1037/h0033743Google Scholar
Bachrach, L. L. (1989) The legacy of model programs. Hospital and Community Psychiatry, 40, 234235.Google Scholar
Bartko, J. J. (1966) The intraclass correlation coefficient as a measure of reliability. Psychology Reports, 19, 311.10.2466/pr0.1966.19.1.3Google Scholar
Bleuler, M. (1978) The Schizophrenic Disorders: Long-Term Patient and Family Studies (trans. Clemens, S. M.). New Haven: Yale University Press.Google Scholar
Brooks, G. W. (1956) Experience with the use of chlorpromazine and reserpine in psychiatry; with special reference to the significance and management of extrapyramidal dysfunction. New England Journal of Medicine, 254, 11191123.10.1056/NEJM195606142542403Google Scholar
Chittick, R. A., Brooks, G. W., Irons, F. S., et al (1961) The Vermont Story. Burlington, VT: Queen City Printers.Google Scholar
Ciompi, L. & Müller, C. (1976) Lebensweg und Alter der Schizophrenen: Eine katamnestische Langzeitstudie bis ins Senium. Berlin: Springer Verlag.10.1007/978-3-662-01606-0Google Scholar
Cousins, N. (1979) The Anatomy of an Illness as Perceived by the Patient. New York: Norton.Google Scholar
Cronbach, L. J. (1951) Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297334.10.1007/BF02310555Google Scholar
Deane, W. N. & Brooks, G. W. (1963) Chronic schizophrenics view recovery. Journal of Existential Psychiatry, 4, 121130.Google Scholar
DeSisto, M. J., Harding, C. M., Howard, M. A., et al (1991) Perspectives on Rural Mental Health: A Comparison of Mental Health System Policy and Program Development in Maine and Vermont. Augusta, ME: Kennebec Press.Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L., et al (1976) The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766771.10.1001/archpsyc.1976.01770060086012Google Scholar
Fleiss, J. L. (1973) Statistical Methods for Rates and Proportions, pp. 218223. New York: Wiley.Google Scholar
Folstein, M. F., Folstein, F. E. & McHugh, P. R. (1975) Mini-mental state. Journal of Psychiatric Residency, 12, 189198.10.1016/0022-3956(75)90026-6Google Scholar
Harding, C. M. (1988) Course types of schizophrenia: an analysis of European and American studies. Schizophrenia Bulletin, 14, 633643.10.1093/schbul/14.4.633Google Scholar
Harding, C. M. & Brooks, G. W. (1984) Life assessment of a cohort of chronic schizophrenics discharged 20 years ago. In The Handbook of Longitudinal Research, vol. II (eds S. Mednick, M. Harway & K. Finello), pp. 375393. New York: Praeger.Google Scholar
Harding, C. M. & Brooks, G. W. (1986) Speculations on the measurement of recovery from severe psychiatric disorder and the human condition. Psychiatric Journal of the University of Ottawa, 11, 199204.Google Scholar
Harding, C. M. & Brooks, G. W.Ashikaga, T., et al (1987a) The Vermont longitudinal study of persons with mental illness, I: methodology, study sample, and overall status 32 years later. American Journal of Psychiatry, 144, 718726.Google Scholar
Harding, C. M. & Brooks, G. W.Ashikaga, T., et al (1987b) The Vermont longitudinal study of persons with mental illness, II: long-term outcome of subjects who retrospectively met DSM–III criteria for schizophrenia. American Journal of Psychiatry, 144, 727735.Google Scholar
Harding, C. M.Consalvo, C. M., Landerl, P. S., et al (1981) The Vermont Longitudinal Questionnaire. Burlington, Vermont.Google Scholar
Harding, C. M., McCormick, R. V., Strauss, J. S., et al (1989) Computerised life chart methods to map domains of function and illustrate patterns of interactions in the long-term course trajectories of patients who once met the criteria for DSM–III schizophrenia. British Journal of Psychiatry, 155 (suppl. 5), 100106.10.1192/S0007125000296062Google Scholar
Huber, G., Gross, G. & Schüttler, R. (1975) A long-term follow-up study of schizophrenia: psychiatric course of illness and prognosis. Acta Psychiatrica Scandinavica, 53, 4957.10.1111/j.1600-0447.1975.tb00022.xGoogle Scholar
Kraepelin, E. (1902) Clinical Psychiatry: A Textbook for Students and Physicians (6th edn of Lehrbuch der Psychiatrie) (trans. Defendorf, A. R.). New York: Macmillan.Google Scholar
Kunce, J. T. (1970) Is work therapy really therapeutic? Rehabilitation Literature, 31, 297299.Google Scholar
Leighton, A. H. & Leighton, D. C. (1949) Gregorio, the Handtrembler: A Psychobiological Personality Study of a Navajo Indian. Peabody Museum Papers. Cambridge: Harvard University Press.Google Scholar
Lovejoy, M. (1984) Recovery from schizophrenia: a personal Odyssey. Hospital and Community Psychiatry, 35, 809813.Google Scholar
McGlashan, T. H. (1986) The prediction of outcome in chronic schizophrenia: IV. The Chestnut Lodge follow-up study. Archives of General Psychiatry, 43, 167176.10.1001/archpsyc.1986.01800020077010Google Scholar
McGlashan, T. H. (1988) A selective review of recent North American long-term follow-up studies of schizophrenia. Schizophrenia Bulletin, 14, 515542.10.1093/schbul/14.4.515Google Scholar
McGlashan, T. H. (1991) A selective review of recent North American long-term follow-up studies of schizophrenia. In Psychiatric Treatment: Advances in Outcome Research (eds S. Martin, J. Goset & S. Grob), pp. 61105. Washington, DC: APA.Google Scholar
McGlashan, T. H. & Bardenstein, K. K. (1990) Gender differences in affective, schizoaffective, and schizophrenic disorders. Schizophrenia Bulletin, 16, 319329.10.1093/schbul/16.2.319Google Scholar
Meyer, A. (1951) The life chart and the obligation of specifying positive data in psychopathological diagnosis. Reprinted in The Collected Papers of Adolf Meyer (ed. Winters, E. E.), pp. 5256. Baltimore: Johns Hopkins University Press.Google Scholar
Morrissey, J. P. & Goldman, H. H. (1984) Cycles of reform in care of the chronically mentally ill. Hospital and Community Psychiatry, 35, 785793.Google Scholar
Pedhazur, E. J. (1982) Multiple Regression in Behavioral Research. New York: CBS College Publishing.Google Scholar
Strauss, J. S. & Carpenter, W. T. (1972) The prediction of outcome in schizophrenia, I: Characteristics of outcome. Archives of General Psychiatry, 27, 739746.10.1001/archpsyc.1972.01750300011002Google Scholar
Strauss, J. S. & Carpenter, W. T. (1977) Prediction of outcome in schizophrenia, III: five-year outcome and its predictors. Archives of General Psychiatry, 34, 159163.10.1001/archpsyc.1977.01770140049005Google Scholar
Tsuang, M., Woolson, R. & Fleming, J. (1979) Long-term outcome of major psychoses, I: schizophrenia and affective disorders compared with psychiatrically symptom-free surgical conditions. Archives of General Psychiatry, 36, 12951301.10.1001/archpsyc.1979.01780120025002Google Scholar
Zubin, J. (1985) General discussion – Proceedings of the 74th Annual American Psychopathological Meeting, New York, March 1–3, 1984. In Controversies in Schizophrenia: Changes and Constancies (ed. Alpert, M.), pp. 406407. New York: Guilford Press.Google Scholar
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