Predicting Symptomatic and Behavioural Outcomes of Community Care

BACKGROUND Many studies of community care show little overall improvement in patient functioning. This study investigated whether cognitive impairment mediates the effect of the increased opportunities offered by the community. METHOD Behaviour, symptoms, sociodemographic variables and information processing of a random sample of chronic psychiatric patients were examined. Six years later, social and behavioural outcomes were measured. RESULTS The overall change in the group was negligible. Individual variation can be accounted for by two factors: time since transfer to the community, and initial information processing problems. Patients transferred for at least three years showed significant improvements. Schizophrenic patients without information processing problems improved, but those with deficits got worse. CONCLUSIONS The identification of mediating factors should allow better rehabilitation plans, and alleviate the toxic effects that transfer has on some patients' functioning.

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