Differences between patients with schizophrenia within and without a high security psychiatric hospital

Objective: To report and discuss differences between schizophrenic patients in the community and those in maximum security care. Method: Comparison of 193 community schizophrenic patients with 169 in high security care. Data included case notes, interviews and cognitive tests. Results: Compared to high security patients, community patients tended to be female and married. They had higher school achievement, higher premorbid IQ and better occupational levels, were less likely to have a family history of alcohol abuse, to have had police contact and to have attempted suicide. They had more frequent shorter psychiatric admissions and fewer current and lifetime schizophrenic symptoms. Logistic regression models discriminated the groups with considerable accuracy. Conclusion: Patients needing high security care may be recognizable when schizophrenia is first diagnosed. Progression to the State Hospital seems to result from schizophrenia together with other factors such as deprivation rather than from a worse schizophrenic process per se.