Recovery From Schizophrenia: Psychiatry And Political Economy

THE POLITICAL ECONOMY OF SCHIZOPHRENIA 153symptoms at all and 69 per cent had no psychotic symptoms; half of the patientswere rated by a psychiatrist as having made a normal adjustment and 58 per centwere considered normal by their families. Clearly, these people were well notmerely by virtue of the tolerance of their family members, they were well by anumber of standards. 26Hong KongPsychiatrists W.H.Lo and T.Lo attempted to follow up, after an interval of tenyears, all of the patients with schizophrenia who lived on Hong Kong Island andhad first attended the Hong Kong Psychiatric Centre in 1965. They were able toevaluate only 82 out of the original 133 patients. Their outcome results for thisdensely urbanized manufacturing center are intermediate between those forEuropean patients and those for people with schizophrenia in Mauritius and SriLanka. A substantial number of their subjects had a relapsing course to theirillness, but at follow-up 65 per cent were free of psychotic symptoms and asimilar proportion had achieved good social recovery. 27 The outcome for thesepatients compares favorably with the estimated 45 per cent social recovery rate forWesterners with schizophrenia (see Chapter 3).SingaporeIn a study conducted by three British-trained psychiatrists, Drs Tsoi, Kok andChew, an effort was made to trace all 637 patients with a diagnosis of schizophreniawho were admitted for the first time to Woodbridge hospital in Singapore during1975. Five years after admission, 424 were located and reexamined. Despite thefact that many cases could not be traced, and that those who were reassessedincluded the patients who fared poorly and required readmission to hospital, theoutcome results were very favorable. Complete recovery was observed in 35 percent of cases and only minimal illness in a further 28 per cent. A later study of thesame patients showed 15-year outcome to be very similar. These results are verysimilar to those for Hong Kong, both sites being densely populated cities. Nearlytwo thirds of the patients in the Singapore study were working at five-year followup.At that time labor was in short supply and jobs for patients were easy to comeby. 28Three Indian citiesA team of psychiatrists, headed by Dr Verghese, conducted a five-year followupstudy of all of the patients attending three Indian clinics, in Lucknow, Vellore andMadras, in 1981–82 who suffered from schizophrenia of less than two yearsduration. Out of 386 patients identified, 323 were successfully traced andinterviewed. Sixty-six per cent of the patients displayed a favorable overalloutcome on a combination of measures; 64 per cent were free of psychotic