TRANSITION FROM ACUTE TO MAINTENANCE TREATMENT - PREDICTION OF STABILIZATION

The stabilization period that follows the exacerbation of a schizophre nic illness represents a critical point in the course of the illness. Successful stabilization is a prerequisite to long-term tenure in the community and the possibility of improvement in functional outcome. In this paper we present an operational definition of stabilization deve loped in the context of a study of long-term maintenance treatment tha t incorporates time, symptomatic equilibrium and consistency of medica tion dosage. Patients were identified at the time of hospitalization a nd followed prospectively to determine whether or not they met stabili zation criteria. Characteristics that predicted successful stabilizati on included measures drawn from the domains of patient personal charac teristics and psychiatric history, symptoms of psychopathology and sid e effects in response to initial treatment and family judgments. These patients were treated primarily with fluphenazine decanoate, and five distinct dosing strategies with this agent were identified retrospect ively. The dosing strategies distinguished the length of time to subse quent stabilization. The implications of these findings for clinical m anagement of schizophrenia are discussed.