The goal of this RSA project is to allow the candidate to continue his studies on the course of schizophrenia and related psychiatric disorders. At this stage, these efforts focus on developing an empirically-based model of the processes leading to improvement in these disorders. Given the considerable evidence that many factors are involved in the course of these disorders, such a model is necessary to provide a basis for understanding, for more specific treatment interventions, and for focused hypothesis-testing research. In order to achieve this goal, a study will be carried out involving the systematic assessment of four groups of subjects: a group of patients with an extended history of schizophrenia who will be treated with the medication clozapine; leaders and members of patient consumer groups; patients who have been discharged from psychiatric hospitalization and have already been followed in a two-year follow-along study of their course; and patients discharged in the past from state hospitals and already involved in an informal study in which videotape records have been kept documenting their adaptation to community living. These four groups present a unique opportunity to study people with schizophrenia and related mental disorders who have improved or are likely to improve during the course of the project. Such a study has never been possible previously. Subjects will be interviewed with semi-structured instruments and rated on standard scales to assess their levels of symptomatology and social functioning, changes in these, and the patterns and sequences in these changes over time. Patient diagnostic, psychiatric history, and demographic data will also be collected and subjects' treatment and environmental contexts and efforts on their own behalf will also be recorded. These data will be analyzed with qualitative and quantitative methods to suggest pathways to improvement that are found and to suggest key factors in treatments, the environment, and in patients' own efforts that have been important in achieving these paths. Persons who improve will be compared with those who have not to suggest factors and longitudinal sequences that may account for these differences. Operational definitions for phases described in previous research will be completed and preliminary hypothesis-testing will be carried out. The data generated from this project will provide a range of information on a heterogeneous group of patients who improve to suggest the nature of the processes involved in improvement and approaches to more focused treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Scientist Award (K05)
Project #
5K05MH000340-12
Application #
3075701
Study Section
Research Scientist Development Review Committee (MHK)
Project Start
1980-12-01
Project End
1996-05-31
Budget Start
1992-06-01
Budget End
1993-05-31
Support Year
12
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Yale University
Department
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Strauss, J S (1994) The person with schizophrenia as a person. II: Approaches to the subjective and complex. Br J Psychiatry Suppl :103-7
Davidson, L; Strauss, J S (1992) Sense of self in recovery from severe mental illness. Br J Med Psychol 65 ( Pt 2):131-45
Strauss, J S (1992) The person-key to understanding mental illness: towards a new dynamic psychiatry, III. Br J Psychiatry Suppl :19-26
Strauss, J S (1991) The person with delusions. Br J Psychiatry Suppl :57-61
Strauss, J S; Rakfeldt, J; Harding, C M et al. (1989) Psychological and social aspects of negative symptoms. Br J Psychiatry Suppl :128-32
Strauss, J S (1989) Mediating processes in schizophrenia. Towards a new dynamic psychiatry. Br J Psychiatry Suppl :22-8
Rakfeldt, J; Strauss, J S (1989) The low turning point. A control mechanism in the course of mental disorder. J Nerv Ment Dis 177:32-7
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. Br J Psychiatry Suppl :100-6
Strauss, J S (1989) Subjective experiences of schizophrenia: toward a new dynamic psychiatry--II. Schizophr Bull 15:179-87
Greenfeld, D; Strauss, J S; Bowers, M B et al. (1989) Insight and interpretation of illness in recovery from psychosis. Schizophr Bull 15:245-52

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