Keynote Lecture: Life-Oriented Approach to Treatment and Simple Functional Tests for Clinical Practice

摘要

Life-oriented treatment was formulated when the Five-Year Project Aimed at Preventing the Relapse of Schizophrenia was introduced at the Gunma University Hospital between 1958 and 1962. A cohort of 140 patients was followed along their life courses. Two guiding aspects were identified: the patients' value-attributions and stress resulting from their environment. The 25-year follow-up is described with special reference to social adjustment. Although the initial aim of relapse prevention failed, the subsequent episodes became shorter and milder. A trend of bifurcation between self-support and hospitalization continued for 20 years and resulted in a dichotomy. To examine the basic mental functions, a low-tech test battery was constructed for clinical use: a simple reaction time is obtained from the time to catch a falling ruler, a mild stress-induced pulse rate difference, at the blood-pressure measurement, and a degree of randomness, from a random number generation test. The markers in combination show an abnormality in 85% of the schizophrenic group compared with 30% for normal controls and correlate with negative symptoms and social adaptability. According to the Baum test, an unusual type of drawing appears frequently in acute cases. This is indicative of a destruction of gestalt formation.