The Chronic Patient With a Nonpsychotic Diagnosis
Richard S. Green M.D.1 and
Paul F. Koprowski M.S.W.2
1 Department of Psychiatry Long Island Jewish-Hillside Medical Center New Hyde Park, New York
2 Clinical Institute of Human Relationships San Diego, California
In a population of almost 1,100 patients in an urban hospital's aftercare program for the chronically mentally ill, 137 patients (12.5 per cent) were found to have nonpsychotic diagnoses. Patients with nonpsychotic diagnoses tended to be older at the first psychiatric contact, a preponderance were first-born or only children, and a higher percentage had been or were presently married. The therapist's possible role in the prevention of chronicity in nonpsychotic patients is discussed; therapists may contribute to the creation of chronic patients, the authors say, by fostering the emergence of increased dependency needs in patients who initially present with acute symptoms. The limitations of psychotherapeutic intervention must be stressed to psychotherapy students, and psychotherapy with nonpsychotic patients should be time-limited and focused on problem-solving.
