Outpatients with schizophrenia and bipolar I disorder: Do they differ in their cognitive and social functioning?

The authors used a battery of cognitive and social functioning measures to evaluate stable outpatients with schizophrenia (n=74) and bipolar I disorder (n=26) who were receiving care at community and rehabilitation programs. The groups did not differ significantly on 36 of 41 measures. For most variables, comparisons between groups yielded effect sizes of <0.5. These results suggest that individuals with bipolar I disorder receiving community and rehabilitation services have many social and cognitive deficits that are as severe as those in schizophrenia.

A mental health center's influence in a county jail.

A case study that describes the process of establishing mental health services in the medium-sized Howard County (Maryland) jail is presented. Built in 1878, the county jail provided virtually no rehabilitative services to its inmates until 1972. At that time, personnel from the Howard County Bureau of Mental Health began to gain access to the jail, establish rapport with the jail staff, assess the mental health needs of the inmates, and implement various programs to meet these needs. Implementation and development of services are described for the 12-year span between 1972 and 1984. The concept of providing community-based services has been accepted and incorporated into the value system and structure of the jail. It is concluded that the viability of programs depended upon interactions among continuation of strong leadership for each component of the rehabilitation program, acceptance of the value of these services by the jail administration and staff, and availability of community resources. The linkage between the jail and community agencies is discussed.

Subjective quality of life in out-patients with schizophrenia: clinical and utilization correlates.

The relationship between subjective quality of life (QOL), clinical measures, and service utilization was measured in out-patients with schizophrenia. A total of 72 subjects completed the Quality of Life Interview and were also assessed by means of the Positive and Negative Syndrome Scale, a battery of neuropsychological tests, and two measures of social functioning. Use of psychiatric services over a 2-year period was ascertained from comprehensive records. Global subjective QOL was lower than patients' satisfaction with specific life domains. There were few significant correlations between satisfaction with, and objective measures of, specific life areas. In a multiple regression, patients' global subjective QOL was inversely related to their scores on the PANSS depression factor, and to the number of psychiatrist out-patient visits.

Neuropsychological deficits in chronic schizophrenics. Relationship with symptoms and behavior.

Thirty-nine hospitalized chronic schizophrenics were administered the Luria-Nebraska Neuropsychological Battery (LNNB) and the Weschler Adult Intelligence Scale-Revised when they were clinically stable. Test variables were related to Brief Psychiatric Rating Scale ratings and two behavioral measures of ward functioning, points and activities. Spearman correlations of test variables with the symptom and behavioral measures were entered into a series of median polish analyses. There was an overall significant relationship between the two sets of variables. Neuropsychological test variables that were most highly correlated with symptom/behavioral measures were LNNB Left Frontal, Memory, and Intellectual Processes scales. The positive symptoms of thought disorder and hallucinations were most consistently related to neuropsychological variables. In contrast with other findings in the literature, negative symptoms were not significantly correlated with neuropsychological performance.