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BACKGROUND Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. AIMS To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course(More)
Resurgent hopes for recovery from schizophrenia in the late 1980s had less to do with fresh empirical evidence than with focused political agitation. Recovery's promise was transformative: reworking traditional power relationships, conferring distinctive expertise on service users, rewriting the mandate of public mental health systems. Its institutional(More)
OBJECTIVE The study evaluated the effectiveness of a three-year outpatient commitment pilot program established in 1994 at Bellevue Hospital in New York City. METHODS A total of 142 participants were randomly assigned; 78 received court-ordered treatment, which included enhanced services, and 64 received the enhanced-service package only. Between 57 and(More)
BACKGROUND Established legal mandates and high expectations for psychiatric advance directives are not matched by empirical evidence documenting their actual implementation. AIMS To explore the interests, concerns and planning activities of informed mental health service users contemplating such directives. METHOD Standard qualitative research(More)
OBJECTIVE Despite decades of deinstitutionalization, individuals with psychiatric disabilities living outside the hospital may be described as in the community, but not of it. To effectively address the persisting problem of social exclusion of persons with psychiatric disabilities, new conceptual tools are needed. To address this need, a new definition of(More)
OBJECTIVE This paper compares the prevalence of mental illnesses and alcohol and drug abuse and the residential histories of homeless individuals identified as having a mental illness and individuals who are not so identified. The cohort consisted of single persons applying for shelter over a 12-week period in Westchester County, a suburban county in New(More)
Although psychiatric stigma in China is particularly pervasive and damaging, rates of high expressed emotion ("EE" or family members' emotional attitudes that predict relapse) are generally lower than rates found in Western countries. In light of this seemingly incongruous juxtaposition and because Chinese comprise approximately one-fifth of the world's(More)
Drawing on ongoing fieldwork in New York City, the authors distinguish two "genealogies," or developmental traditions, of supported housing. "Housing as housing" originated in the mental health field to champion normalized, less-structured alternatives to clinically managed residential programs. "Integrated housing development" traces its origins to the(More)
OBJECTIVE Quality of life, once a priority in caring for people with severe mental illness, has since been eclipsed by other concerns. This article returns attention to quality of life by offering a theory of social integration (as quality of life) for persons disabled by severe mental illness. METHODS Data collection for this qualitative study consisted(More)
Received wisdom and a substantial body of epidemiological work indicate that early psychosis bodes ill for matrimonial prospects. Using follow-up data from ISoS, the WHO-Collaborative International Study of Schizophrenia, we confirm an earlier local finding that marital success, 15 years after first-break psychosis, is quite favourable in India: 74% for(More)