Contents:

1 Background and Goals of the Study.- 1.1 Illness Models of Schizophrenia.- 1.2 The Goals of the Study and Their Connection with the Local Health Care System.- 2 Prognosis of Schizophrenia and the Research on Psychosocial Modes of Therapy.- 2.1 General View of the Prognosis and Factors Contributing to It.- 2.2 Effect of Neuroleptic Medication on the Prognosis.- 2.3 Studies on the Effect of Psychotherapy and Other Psychosocial Modes of Treatment.- 2.3.1 Individual Psychotherapy.- 2.3.2 Family Therapy.- 2.3.3 Group Therapy.- 2.3.4 Other Studies.- 3 Study Project, Material and Methods.- 3.1 Beginning of the Project and the Patient Series.- 3.1.1 The Research Team and the Planning of the Project.- 3.1.2 Diagnostic Criteria for Inclusion in the Series.- 3.1.3 Inclusion of the Patients in the Series.- 3.2 Course of the Project.- 3.2.1 Psychiatric Basic Examination.- 3.2.2 Psychologic Basic Examination.- 3.2.3 Action Research by the Team.- 3.2.4 Two-Year Psychiatric Follow-up.- 3.2.5 Two-Year Psychologic Follow-up.- 3.2.6 Five-Year Psychiatric Follow-up.- 3.3 Data Analysis and Statistical Methods.- 4 Findings of Psychiatric Basic Examination. Indications of Therapeutic Plans.- 4.1 Psychosocial Background of Patients.- 4.1.1 Sex and Age.- 4.1.2 Family Background.- 4.1.2.1 Mental Health of Members of Primary Family.- 4.1.2.2 Atmosphere and External Structure of Primary Family.- 4.1.2.3 Social Background of Primary Family.- 4.1.3 Prepsychotic Development of Patients.- 4.1.3.1 Physical and Psychologic Development.- 4.1.3.2 Social Development.- 4.1.3.3 Data on the Patients' Secondary Families.- 4.1.3.4 Relatives' Attitudes Towards the Patient.- 4.2 Admission for Treatment and the Clinical Background Variables.- 4.2.1 Previous Treatments. Admission for Present Treatments.- 4.2.2 Clinical Pictures.- 4.2.3 Categories Constructed on the Basis of the Quality of Ego Dysfunctions (Ego-Dynamic Sub-Grouping).- 4.3 Case-Specific Therapeutic Plans.- 4.3.1 Intervention in Crisis.- 4.3.2 Individual Therapies.- 4.3.3 Family Therapies.- 4.3.4 Group Therapy of Out-Patients.- 4.3.5 Psychotherapeutic Community on a Hospital Ward.- 4.4 Summary and Discussion.- 5 Implementation of Therapies and Factors Influencing It.- 5.1 Use of In-Patient and Out-Patient Treatment.- 5.1.1 In-Patient Treatment.- 5.1.1.1 The Length and Number of the In-Patient Periods.- 5.1.1.2 Did a Longer First Hospital Period Lessen the Need for Later Hospital Treatments?.- 5.1.2 Out-Patient Care.- 5.2 Implementation of Psychotherapeutic Treatments.- 5.2.1 Initial Intervention in Crisis.- 5.2.2 Individual Therapies.- 5.2.2.1 The Therapeutic Orientation.- 5.2.2.2 Number and Frequency of the Sessions.- 5.2.2.3 Connections with the Background Variables.- 5.2.3 Family Therapy.- 5.2.3.1 The Therapeutic Orientation.- 5.2.3.2 Number and Frequency of the Sessions.- 5.2.3.3 Connections with the Background Variables.- 5.2.3.4 Supportive Contacts with Family Members.- 5.2.4 Treatment in a Psychotherapeutic Community.- 5.2.4.1 Therapeutic Orientation.- 5.2.4.2 Connections with the Background Variables.- 5.2.5 Group of Psychotherapy Cases.- 5.2.5.1 Criteria of Inclusions. Combinations of Different Therapeutical Models.- 5.2.5.2 Connections with the Background Variables.- 5.2.6 Patients Remaining Excluded from the Psychotherapeutic Treatments.- 5.2.7 Occupational Groups, Psychotherapeutic Training and Supervision of the Therapists.- 5.2.8 Discontinued Therapies.- 5.3 Somatic Treatments.- 5.3.1 Neuroleptic Medication.- 5.3.2 Other Somatic Treatments.- 5.4 Social and Rehabilitative Measures.- 5.5 Selection of the Mode of Therapy in the Light of the Psychologic Basic Examination.- 5.5.1 Internal Object World and Motivation to Therapy.- 5.5.2 Inclusion in and Exclusion from the Group of Psychotherapy Cases.- 5.5.3 Implementation of Individual Therapy.- 5.5.4 Selection for Family Therapy.- 5.5.5 Selection for Community Therapy.- 5.5.6 Selection for Pharmacotherapy.- 5.5.7 Summary.- 5.6 Summary and Discussion.- 6 Prognosis and the Effect of Therapies on It.- 6.1 How Was the Prognosis Measured?.- 6.1.1 Implementation of the Prognostic Study.- 6.1.2 Sub-Areas of the Prognostic Study.- 6.1.3 Credibility of the Prognostic Findings: Comparison of the Two-Year Follow-up Findings Made By the Team and the Independent Examiner.- 6.2 Clinical Prognosis.- 6.2.1 Patients Who Died Or Were Not Reached for the Follow-up Examination.- 6.2.2 Occurrence of Psychotic Symptoms.- 6.2.3 Occurrence of Nuclear Symptoms of Schizophrenia.- 6.2.4 Suicidal Tendencies and Violence.- 6.2.5 Other Observations on the Patient's Clinical Status. Phenomenon of Defencelessness.- 6.2.6 Summary and Discussion.- 6.3 Psychodynamic Prognosis.- 6.3.1 Psychosexual Development.- 6.3.2 Development of Interpersonal Relationships.- 6.3.3 Insight and Sense of Illness.- 6.3.4 Summary and Discussion.- 6.4 Psychosocial Prognosis.- 6.4.1 Working Capacity.- 6.4.2 Social Role and Disability Pensions.- 6.4.3 Dwelling Conditions.- 6.4.4 Occupational Identity and Its Development.- 6.4.5 Maintenance or Loss of the Grip on Life.- 6.4.6 Summary and Discussion.- 6.5 Prognosis in the Light of Hospital Treatments.- 6.5.1 In-Patient Days During the Follow-up Years.- 6.5.2 Patients Treated in Hospital During the Last Two Follow-up Years.- 6.5.3 Summary and Discussion.- 6.6 Development of Families and Family Relationships.- 6.6.1 Psychic Health and Family Members.- 6.6.2 Follow-up of the Marital Relationships.- 6.7 Effects of Psychotherapy and Medication on Prognosis: Statistical Analysis.- 6.7.1 Inclusion in the Group of Psychotherapy Cases and Medication.- 6.7.2 Intensive Individual Therapy and Treatment in a Psychotherapeutic Community.- 6.7.3 Global Prognostic Assessment According to Strauss and Carpenter Outcome Scale.- 6.7.4 Summary and Discussion.- 6.8 Prognosis and the Factors Affecting It: Summary and Discussion.- 6.8.1 Comparison of the Different Sub-Areas of Prognosis.- 6.8.2 Patient-Specific Background Factors As Predictors of the Prognosis.- 6.8.3 Conclusions of the Effect of Treatment.- 7 Development of Need-Specific Treatment of Schizophrenic Psychoses.- 7.1 Need-Specificity of Treatment As Concept.- 7.2 Implementation of Need-Specific Treatment in Our Project and the Factors Affecting It.- 7.3 Need-Specificity and Prognosis of Treatment.- 7.4 Indications of Psychotherapeutic Treatments: Five Patient Groups Differentiated on the Basis of Primary Therapeutic Concern.- 7.4.1 Primary Treatment Long-Term Individual Therapy.- 7.4.2 Primary Treatment Couple Therapy Or Conjoint Therapy of the Patient's Procreated Family.- 7.4.3 Primary Treatment Conjoint Therapy of the Patient's Family of Orientation.- 7.4.4 Primary Treatment Flexible Family- and Environment- Oriented Intervention in Crisis.- 7.4.5 Primary Treatment Extensive Support to the Patient to Help Him Cope in His Social Environment.- 7.4.6 Discussion.- 7.5 Prerequisites for Developing Need-Specific Treatment.- 8 Towards Need-Specific Treatment of Schizophrenic Psychoses: Summary.- 8.1 Goals of the Study and Methodologic Planning.- 8.2 Findings of the Initial Psychiatric Examination.- 8.3 Implementation of Treatments.- 8.4 Prognosis and Factors Contributing to It.- 8.5 Development of Need-Specific Treatment of Schizophrenic Psychoses.- Appendices 1 - 10.- References.