EFFECTIVENESS OF CLOZAPINE AND A SOCIAL-LEARNING PROGRAM FOR SEVERELYDISABLED PSYCHIATRIC-INPATIENTS

Objective: This study examined the combined effectiveness of clozapine and a comprehensive inpatient psychosocial rehabilitation program on the clinical functioning and aggressive behaviors of patients with chr onic schizophrenia. Methods: Two groups of 11 subjects each were selec ted from among patients being treated in the social learning program a t Fulton (Mo.) State Hospital. Group 1 subjects were placed on clozapi ne at various times after the intr oduction of the program, while grou p 2 subjects remained on traditional antipsychotics throughout the stu dy period. Group 1 and group 2 subjects were matched on clinical funct ioning as measured by the Time-Sample Behavioral Checklist (TSBC). For each subject, scores on six TSBC subscales were examined at five time points. Data were analyzed using repented-measures multiple analysis of variance and univariate analyses of variance. Data on frequency of aggressive behaviors were aggregated into three six-month time periods and were analyzed using Wilcoxon signed-rank tests. Results: Both gro ups demonstrated significant improvement on several measures. However, the addition of clozapine resulted in accelerated improvement for gro up 1 subjects, especially in aggressive behaviors. Conclusions: Compre hensive psychosocial treatment programming resulted in significant imp rovements in clinical functioning for many inpatients, Clozapine may e nhance responsiveness to such programming for some patients.