Studies of the Doctor as a Crucial Factor for the Prognosis of Schizophrenic Patients

A review is presented of some studies re the nature of the transactions between schizophrenic patients & their MD's, & the diff'ial characterizations of those MD's who have a high % of their patients improve as contrasted with those who have a relatively lower % of improved patients. A study was done on 7 psychiatrists (A) at the Henry Phipps Psychiatric Clinic who had averaged an improvement rate of 75% in their 48 schizophrenic patients, & the work of 7 (B) who had a 27% improvement in 52 such patients. A study of clinical records showed that schizophrenic patients who improve show in their COMM's to their MD's manifestations of confidence & trust, including the discussion of personal problems. It was found that the (B) MD's had a tendency either to be passively permissive or to point out to a patient his mistakes & misunderstandings & to interpret his behavior in an instructional style, whereas the (A) MD's did little interpretation or instruction, but did express personal att's freely on problems that were being talked about by the patient, & set limits on the kind & degree of obnoxious behavior permitted. % rates improved for these patients at follow-up 5 yrs or more later are presented. A 2nd group of MD's was tested by using the Strong Vocational Interest inventory, & results supported the general statement that schizophrenic patients do not respond well to MD's who are mechanically inclined & who are themselves characterized by a marked desire to know the right or wrong way to do things. There is evidence also in further findings that the less effective MD's are themselves emotionally resistant to accepting the leadership of others. E. Weiman.