And If That Doesn't Work, What Next ... ?: A Study of Treatment Failures in Schizophrenia

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The data for this study were collected over the years 1959 to 1963, before institutional review boards were established. Individual consent was obtained in each case, and ethical considerations were a prominent consideration in the design. Indeed, the present study is possible only because ethical considerations indicated that the patients who failed to respond to their original treatment should be followed-up carefully and provided with whatever was considered at the time to be the treatment that was most likely to succeed if the original treatment had failed. We believe that present day review boards would endorse this decision.A systematic study of schizophrenic patients who did not respond satisfactorily to one of five different forms of treatment given under controlled conditions showed that almost all of them responded satisfactorily to subsequent treatment with the combination of ataraxic drugs and group psychotherapy. Whatever the original form of treatment, and despite subsequent retreatment with drugs and group psychotherapy, there was a treatment-resistant core—a few patients who either responded very slowly or who improved relatively little.

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