Follow-Up of Treatment Failure: Psychosis and Character Disorder

Sixty-one patients transferred from an open hospital to a more authoritarian setting because of unmanageable behavior or anticipated inability to adjust were followed up. Ninety-one percent of those diagnosed by a research psychiatrist as having character disorders, most of whom had been considered schizophrenic by the hospital staff, reversed their destructive patterns and achieved early discharge. The authors discuss the regressive pull of nonauthoritarian treatment for certain types of character disorders and contrast this with a relative lack of environmental impact on refractory psychotic patients.