Prediction of hospitalizations by schizophrenia patients' assessment of treatment: an expanded study

This study examines whether schizophrenia patients' global assessment of tr eatment predicts outcome in community care. Eighty-five patients rated the extent to which their treatment was right for them. The outcome measure was assessed by means of a hospitalization index reflecting the duration of fu ll and partial hospitalization within a follow-up period of 24 months. Pati ents who dropped out (n = 21) assessed their treatment more negatively than those who remained in the care system during follow-up. Patients with no h ospitalization (n = 25) expressed a more negative assessment than patients who were hospitalized in the follow-up period at least once (n = 39). In th is latter subgroup, however, patients with a more negative assessment had a longer duration of hospitalization during follow-up, and patients' assessm ent of treatment was the best single predictor of outcome (r = -0.50, P < 0 .01). In a multiple regression analysis, patients' assessment of treatment, the number of previous hospitalizations and the hospitalization index in t he two years prior to the interview, together, explained approximately half of the variance of outcome (adjusted R-2 = 0.46). The findings underline t he relevance of asking patients whether treatment is right for them, althou gh the relationship between patients' assessment of treatment and long-term outcome seems more complex than previous studies suggested. (C) 1999 Elsev ier Science Ltd. All rights reserved.