Chronicity in Schizophrenia: Revisited

Abstract

Derived simply from the Greek workchronos, meaning time, the label ‘chronic’ denotes an illness of long duration or one of frequent recurrence. However, when chronic is paired with schizophrenia, as in ‘this person is a chronic schizophrenic’, the connotation becomes an expectation of deterioration, defect, or deficit states (Cutting, 1983). These perceptions about schizophrenia have pervaded and guided clinical judgements (Feighneret al, 1972; American Psychiatric Association, 1980, 1987), treatment programming (Bachrach, 1979; Lamb, 1981; Strauss & Glazer, 1982), policy formulation (Greenblatt, 1978; Talbott, 1979), and decisions about priority for funding (Kraft, 1981). These perceptions have also stripped hopes of recovery from patients and their families (Chamberlin, 1979; Lovejoy, 1984). Further, the use of phrases such as ‘deinstitutionalisation of chronic mental patients’ glosses over the large heterogeneity of patient types, courses of illness and recovery, and the actual shifts in composition and migrations of groups of patients within society (Lamb, 1979; Leighton, 1982; Harding & Ashikaga, 1982).