Hostname: page-component-848d4c4894-8kt4b Total loading time: 0 Render date: 2024-06-19T19:36:47.077Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric rehabilitation: general issues

Published online by Cambridge University Press:  16 April 2020

H Häfner
H Häfner*
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072Mannheim, Germany
Get access

Summary

Rehabilitation aims at avoiding unfavourable consequences of a disorder and its care and at training and improving impaired and compensatory skills. The needs of the main diagnostic groups with resulting cognitive or social impairments, namely mental retardation, infantile autism, chronic depression, severe psychoneurosis, substance abuse, schizophrenia, and dementia in old age, have specific aspects. An increased need for rehabilitation was prompted by the worldwide movement of deinstitutionalisation, which hit above all the socially most vulnerable schizophrenics. The instruments and methods of rehabilitation for the socially disabled mentally ill go far beyond the sphere of psychiatry. Individualised rehabilitation must be in mutual interaction with the social and occupational environment. The socially disabled individual is, for example, dependent upon awareness and acceptance in the community, upon financial and social support or upon the availability of a job. In the case of persisting deficits, supportive measures at different levels are needed to compensate or to minimize severe consequences of impairments. Their approach is by the social environment with the objective to grant the optimum quality of life combined with a minimum loss of independence. The great variety of measures often required at the same time must be based on a network of services and their purposeful coordination. Psychiatric rehabilitation requires a functioning social system and, in times of scarce resources, political priorities.

Keywords

psychiatric rehabilitationneeds for rehabilitationtraining of impaired skillscompensation of deficitsrehabilitation techniquessocially disabledsocial skills trainingindividualised rehabilitationrehabilitation in schizophrenia
Type
Research Article
Information
European Psychiatry , Volume 11 , Issue S2: The rehabilitation of patients with long-term psychiatric disorders , 1996 , pp. 39s - 50s
Copyright
Copyright © Elsevier, Paris 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bachrach, LLTalbott, JAMeyerson, ATThe chronic psychiatric patient as a “difficult” patient: a conceptual analysis. In: Meyerson, AT eds. Barrien to treating the chronic mentally ill. New Directions For Mental Health Services 1987;Jossey Bass: San Francisco, 33 35–50Google Scholar
Beecham, JKnapp, MCosting psychiatric interventions. In: Thomicroft, GBrewin, CWing, J eds. Measuring mental health needs. London: Gaskell, Royal College of Psychiatrists, 1992; 163–83Google Scholar
Beeson, PGThe bureaucratic context of mental health care. In: Littrel, WBSjoberg, GZürcher, LA eds. Bureaucracy as a social problem. Greenwich, CT: Jai Press, 1983Google Scholar
Biehl, HMaurer, KSchubart, CKrumm, BJung, EPrediction of outcome and utilization of medical services in a prospective study of first onset schizophrenics — results of a prospective 5-year follow-up study. Eur Arch Psychiatr Neurol Sci 1986; 236: 139–47CrossRefGoogle Scholar
Bleuler, MDie schizophrenen Geistesstörungen im Lichte langjähriger Kranken- und Familiengeschichten. Stuttgart: Thieme, 1972Google Scholar
Brenner, HDZur Bedeutung von Basisstörungen für Behandlung und Rehabilitation. In: Böker, WBrenner, HD eds. Bewältigung der Schizophrenie. Multidimensionale Konzepte, psychosoziale und kognitive Therapien. Angehörigenarbeit und autoprospektive Anstrengungen. Bern, Stuttgart, Toronto: Huber, 1986Google Scholar
Brenner, HDHodel, BKube, GRoder, VKognitive Therapie bei Schizophrenen: Problemanalyse und empirische Ergebnisse. Nervenarzt 1987; 58: 72–83Google Scholar
Brown, GLength of hospital stay and schizophrenia. A review of statistical studies. Acta Psych Neuro Scand 1960; 35: 414–30CrossRefGoogle Scholar
Ciompi, LMillier, CHLebensweg und Alter der Schizophrenen. Eine katamnestische Langzeitstudie bis ins SeniumMonographien aus dem Gesamtgebiet der Psychiatrie, Bd.12. Berlin, Heidelberg, New York: Springer, 1976Google Scholar
Falloon, IRHBoyd, JLMcGill, CWRazani, JMoss, HBGilderman, AMFamily management in the prevention of exacerbations of schizophrenia: a controlled study. N Engl J Med 1982; 306: 1437–40CrossRefGoogle ScholarPubMed
Falloon, IRHBoyd, JLMcGill, CW, et al. Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two-year longitudinal studyArch Gen Psychiatry 1985;42:887–96Google Scholar
Falloon, IRHWatt, DCShepherd, MThe social outcome of patients in a trial of long-term continuation therapy in schizophrenia: pimozide vs fluphenazine. Psychol Med 1978; 8: 265–74CrossRefGoogle Scholar
Goldstein, MJRodnick, EHEvans, JRMay, PRSteinberg, MDrug and family therapy in the aftercare treatment of acute schizophrenia. Arch Gen Psychiatry 1978; 35: 1169–77CrossRefGoogle Scholar
Gralnick, ABuild a better state hospital: deinstitutionalization has failed. Hospital Community Psychiatry 1985; 36: 738–41Google ScholarPubMed
Häfner, HRehabilitation Schizophrener. Ergebnisse eigener Studien und selektiver Überblick. Z Klin Psychol 1988; XVII(3): 187–209Google Scholar
Häfner, Han der Heiden, WEvaluation gemeindenaher Versorgung psychisch Kranker. Arch Psychiatr Nervenkrankh 1982; 232: 71–95CrossRefGoogle Scholar
Häfner, Han der Heiden, WThe Mannheim case register: the long-stay population. In: ten Horn, GHMMGiel, RGulbinat, WHHenderson, JH eds. Psychiatric case registers in public health. Amsterdam: Elsevier Science Publishers, 1986; 28–50Google Scholar
Häfner, HMaurer, KLöffner, N, et al. The epidemiology of early schizophreniaBr J Psychiatry 1994;164suppl 23:29–38Google Scholar
Harding, CBrooks, GWAshikaga, TStrauss, JSBreier, AThe Vermont Longitudinal Study: II Long-term outcome of subjects who once met the criteria for DSM-III schizophrenia. Am J Psychiatry 1987; 144: 718–27Google Scholar
an der Heiden, WKrumm, BMüller, SWeber, IBiehl, HSchäfer, MMannheimer Langzeitstudie der Schizophrenie: Grste Grgebnisse zum Verlang der Enkrankuna über 14 Jahre nach stationdrer GrsthehandlungNervaret 1995Google Scholar
Hersen, MBeilack, ASSocial skills training for chronic psychiatric patients. Comprehensive Psychiatry 1976; 17: 559–80CrossRefGoogle ScholarPubMed
Hogarty, GEAnderson, CMReiss, DJ, et al. Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare of schizophreniaArch Gen Psychiatry 1986;43:633–42Google Scholar
Hogarty, GEAnderson, CMReiss, DJFamily psychoeducation, social skills training and medication in schizophrenia. Psychopharmacological Bull 1987; 23: 12–3Google Scholar
Huber, GGross, GSchüttler, RSchizophrenieEine verlaufs-und sozialpsychiatrische Langzeitstudie. Berlin, Heidelberg, New York: Springer, 1979Google Scholar
Jaeger, JDouglas, ENeuropsychiatric rehabilitation for persistent mental illness. Psychiatr Q 1992; 63: 71–94CrossRefGoogle ScholarPubMed
Jaeger, JBerns, STigner, ADouglas, ERemediation of neuropsychological deficits in psychiatric populations: rationale and methodological considerations. Psychopharmacol Bull 1992; 28: 367–90Google ScholarPubMed
Johansen, KHThe impact of patients with chronic character pathology on a hospital inpatient unit. Hospital Community Psychiatry 1983; 34: 842–6Google ScholarPubMed
Jolley, AGHirsch, SIntermittierende und niedrigdosierte Neu-roleptika-Therapie: Prophylaktische Strategien bei der Schizophrenie. In: Olbrich, R eds. Therapie der Schizophrenie. Stuttgart: Kohlhammer, 1990; 53–63Google Scholar
Kane, JMRifkin, AWoemer, MSarantakos, SDose response relationships in maintenance drug treatment for schizophrenia. Psychopharmacology Bull 1986; 6: 205–35Google Scholar
Leff, JInteraction of environment and personality in the course of schizophrenia. In: Häfner, HGattaz, WF eds. Search for the causes of schizophrenia Berlin, Heidelberg, New York: Springer-Verlag, 1991; vol. IIGoogle Scholar
Leff, JThe TAPS project: Evaluating community placement of long-stay psychiatric patients. Br J Psychiatry 1993;162suppl 19Google Scholar
Leff, JPKuipers, LBerkowitz, RVaughn, CHSturgeon, DA controlled trial of social intervention in the families of chronic schizophrenic patients: two-year follow-up. Br J Psychiatry 1985; 141: 121–34CrossRefGoogle Scholar
Liberman, RPWallace, CNeuere Entwicklungen des Trainings sozialer Fertigkeiten für chronisch psychisch Kranke. In: Olbrich, R eds. Therapie der Schizophrenie. Stuttgart: Kohlhammer, 1990; 83–99Google Scholar
Liberman, RPLillie, FFalloon, IRHHarpin, REHutchinson, WStoute, TMSocial skills training for relapsing schizophrenics. An experimental analysis. Behavior Modification 1984; 8: 155–79CrossRefGoogle ScholarPubMed
Marneras, ATsuang, MTAffective and schizoaffective disordersSimilarities and differences. Berlin, Heidelberg: Springer, 1990Google Scholar
Mussgay, LOlbrich, RTrainingsprogramme in der Behandlung kognitiver Defizite Schizophrener: eine kritische WürdigungZ Klin Psych 1988Google Scholar
Olbrich, RDer Einsatz des Personal-Computers in der Rehabilitation psychisch KrankerPresented at AEP Symposium held in Strasbourg, November 19 and 20, 1994Google Scholar
Olbrich, RMussgay, LReduction of schizophrenic deficits by cognitive training: An evaluative study. Eur Arch Psychiatry Neurol Sci 1990; 239: 366–9CrossRefGoogle Scholar
Ritson, BAlcohol and drug related problems held at WHO. community psychiatry symposium Mannheim 1993Google Scholar
Roder, VBrenner, HDSpezifische Therapieinterventionen im kognitiven und sozialen Bereich mit schizophrenen Patienten. In: Olbrich, R eds. Therapie der Schizophrenie. Stuttgart: Kohlhammer, 1990; 100–19Google Scholar
Rössler, WFätkenheuer, BLöffler, WSozialpsychiatrische Dienste — Eine neue institutionelle Versorgungsform zur ambulanten sozialen Rehabilitation chronisch psychisch Kranker. Stuttgart: Enke, 1993 in pressGoogle Scholar
Siegel, JMSpivack, GProblem-solving therapy: the description of a new program for chronic psychiatric patients. Psychotherapy: Theory, Research and Practice 1976; 13: 268–373CrossRefGoogle Scholar
Strathdee, GThomicroft, GCommunity sectors for needs-led mental health services. In: Thomicroft, GBrewin, CRWing, J eds. Measuring mental health needs. London: Gaskell, 1992; 140–62Google Scholar
Talbott, JALamb, HRSummary and recommendation in the homeless mentally illTask force report of the American Psychiatric Association. Washington, DC: Lamb HR, 1984Google Scholar
Tarrier, NBarrowclough, CProceddu, KWatts, SThe assessment of psychophysiological reactivity to the expressed emotion of the relatives of schizophrenic patients. Br J Psychiatry 1988; 152: 618–24CrossRefGoogle ScholarPubMed
Tarrier, NBarrowclough, CVaughn, C, et al. The community management of schizophrenia: a controlled trial of a behavioral intervention with families to reduce relapseBr J Psychiatr 1988;153:532–42Google Scholar
Thurm, I, Häfner, HPerceived vulnerability, relapse rish and coping in schizophrenia. Eur Arch Psychiatr Neurol Sci 1987; 237: 46–53CrossRefGoogle Scholar
Thurm-Mussgay, I, Häfner, HBewältigung der Krankheit Schizophrenie und ihrer Folgen. In: Olbrich, R eds. Therapie der Schizophrenie. Stuttgart: Kohlhammer, 1990; 151–65Google Scholar
Torrey, EFNowhere to go. New York: Harper and Row, 1988Google Scholar
Van Putten, TMarder, SRThe dysphoria syndrome and its relationship to EPS. In: Pichot, PBerner, PWolf, RThau, K eds. Psychiatry, the state of the art. New York: Plenum Press, 1985Google Scholar
Van Putten, TMay, PRA“Akinetic depression” in schizophrenia. Arch Gen Psychiatry 1978; 35: 1101–7CrossRefGoogle Scholar
Vaughn, CELeff, JPThe measurement of expressed emotion in families of psychiatric patients. Br J Soc Clin Psychol 1976; 15: 157–65CrossRefGoogle ScholarPubMed
Wallace, ACNelson, CJLilberman, RP, et al. A review and critique of social skills training with schizophrenic patientsSchizophren Bull 1980;6:42–63Google Scholar
Wing, JBrewin, CRThomicroft, GDefining mental health needs. In: Thomicroft, GBrewin, CRWing, J eds. Measuring mental health needs. London: Gaskell, 1992; 1–17Google Scholar
Wing, JKBrown, GWInstitutionalism and schizophrenia. A comparative study of three mental hospitals 1960–1968 Cambridge: Cambridge University Press, 1970CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.