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Relapse in Schizophrenia

Paul Goldhamer, MD
Arch Gen Psychiatry. 1981;38(7):842-843. doi:10.1001/archpsyc.1981.01780320122016.
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To the Editor.—  This letter is in response to the conclusions reached by Schooler et al (Archives 1980;37:16-24) and Hogarty et al (Archives 1979;36:1283-1294) in their evaluations and comparisons of oral and longacting fluphenazine. Schooler et al contend that "the results suggest that compliance is not an important determinant of relapse among newly discharged schizophrenic patients." Hogarty et al similarly conclude that noncompliance does not adequately explain early schizophrenic relapse.It is my contention that the conflict over compliance is a major determinant of the high relapse rate in schizophrenia and that long-acting neur'oleptics can play an important role in reducing the relapse rate-if proper attention is devoted to important social and psychological ramifications in their use. I believe that the data from the two excellent studies do not contradict my hypothesis, and indeed certain findings of Schooler et al and Hogarty et al point in this direction.Although patients


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