OBJECTIVE: The reorganization in 1981 of a general hospital psychiatric
ward in Oslo, Norway, to achieve a more suitable treatment milieu for
patients with schizophrenia resulted in a change in patients' perceptions
of the ward atmosphere. Reduced group participation and increased
individualized support from staff led patients to perceive of the ward as
having a low level of anger and aggression and a high level of order and
organization. This study examined whether the reorganization was associated
with improved treatment outcome. METHODS: Psychiatrists retrospectively
examined the charts of all patients with a DSM-III-R diagnosis of
schizophrenia or schizophreniform disorder who were admitted to the ward
the year before and the second year after the reorganization. Multiple
regression analyses were used to examine treatment outcomes for both
groups. Outcome was measured indirectly by length of stay, level of
functioning at discharge, and whether the patient was rehospitalized during
the following seven years. RESULTS: Patients treated after the
reorganization had significantly shorter stays with no reductions in either
level of functioning at discharge or length of community tenure after
discharge. Differences in demographic characteristics, illness history, or
psychopharmacological treatment could not account for differences in
outcome. CONCLUSIONS: The results supported the hypothesis that the
organization and milieu of brief-stay wards influence the short-term
outcome of inpatient treatment of patients with schizophrenia.
Abstract Teaser